[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 3775 Introduced in Senate (IS)]

111th CONGRESS
  2d Session
                                S. 3775

  To improve prostate cancer screening and treatment, particularly in 
       medically underserved communities, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 14, 2010

  Mr. Tester (for himself and Mr. Voinovich) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To improve prostate cancer screening and treatment, particularly in 
       medically underserved communities, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Prostate Research, Outreach, 
Screening, Testing, Access, and Treatment Effectiveness Act of 2010'' 
or the ``PROSTATE Act of 2010''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) In 2009, prostate cancer was the second leading cause 
        of cancer death among men.
            (2) In 2009, more than 190,000 new patients were diagnosed 
        with and more than 27,000 men died from prostate cancer.
            (3) In 2009, approximately 2,000,000 people in the United 
        States were living with a diagnosis of prostate cancer and its 
        consequences.
            (4) While prostate cancer generally affects older men, 
        younger men are also at risk of the disease. When prostate 
        cancer appears in early middle age it frequently takes on a 
        more aggressive form.
            (5) There are significant racial, ethnic, population, and 
        geographic disparities with respect to prostate cancer in the 
        United States.
            (6) African-Americans have prostate cancer mortality rates 
        that are more than double the prostate cancer mortality rates 
        among Whites.
            (7) Certain veterans populations may have nearly twice the 
        incidence of prostate cancer than the general population of the 
        United States.
            (8) Underserved rural and highly rural populations have 
        higher rates of mortality than urban populations.
            (9) Urologists are specialists who diagnose and treat the 
        vast majority of prostate cancer patients.
            (10) Investments in basic and translational research have 
        proved promising for the prevention, diagnosis, and treatment 
        of prostate cancer.
            (11) There are many unanswered questions regarding prostate 
        cancer.
            (12) It is not fully understood how much of the known 
        disparities in prostate cancer rates among differing 
        communities are attributable to disease etiology, access to 
        care, or education and awareness of matters relating to 
        prostate cancer.
            (13) The causes of prostate cancer are unknown.
            (14) There are no treatments that can durably arrest growth 
        or cure prostate cancer once it has metastasized.
            (15) A significant proportion (approximately 23 to 54 
        percent) of cases of prostate cancer may be clinically indolent 
        or over-diagnosed, resulting in significant over treatment.
            (16) Good information regarding how to differentiate 
        accurately, early on, between aggressive and indolent forms of 
        prostate cancer is generally unavailable, resulting in 
        significant over treatment.
            (17) More accurate tests for prostate cancer--
                    (A) will minimize the physical, psychological, 
                financial, and emotional trauma that men and their 
                families face; and
                    (B) could increase efficiencies in public and 
                private health care systems that result in the saving 
                of billions of dollars.
            (18) Treatment of prostate cancer has been identified by 
        the Centers for Medicare and Medicaid Services under the 
        Physician Feedback Program established under section 1848(n) of 
        the Social Security Act (42 U.S.C. 1395w-4(n)) as one of eight 
        highest volume, highest cost areas of health care in the United 
        States.

SEC. 3. SENSE OF CONGRESS ON ACCESS TO AND PROVISION AND COORDINATION 
              OF HEALTH CARE FOR DIAGNOSIS AND TREATMENT OF PROSTATE 
              CANCER.

    It is the sense of Congress that--
            (1) innovative and cost-efficient methods to improve access 
        to high-quality health care by underserved, rural, and highly 
        rural populations should take advantage of advances in 
        telehealth to diagnose and treat prostate cancer;
            (2) a coordinated effort between specialists and primary 
        care physicians is essential to provide the most effective 
        diagnosis and treatment plan for prostate cancer patients;
            (3) prostate cancer research and health care programs 
        across Federal agencies should be coordinated--
                    (A) to improve transparency and accountability;
                    (B) to encourage the translation of research into 
                practice;
                    (C) to identify and implement best practices; and
                    (D) to foster an integrated and consistent focus on 
                effective prevention, diagnosis, and treatment of 
                prostate cancer.

SEC. 4. INTERAGENCY PROSTATE CANCER COORDINATION AND EDUCATION TASK 
              FORCE.

    (a) Establishment.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall, in conjunction with the Secretary of Defense and the 
        Secretary of Health and Human Services, establish a task force 
        on the coordination of Federal activities relating to prostate 
        cancer.
            (2) Designation.--The task force established under 
        paragraph (1) shall be known as the ``Interagency Prostate 
        Cancer Coordination and Education Task Force'' (in this section 
        referred to as the ``Task Force'').
    (b) Membership.--
            (1) Composition.--The Task Force shall be composed as 
        follows:
                    (A) Such representatives of the Department of 
                Veterans Affairs and such program areas of the 
                Department as the Secretary of Veterans Affairs 
                considers appropriate for the purpose of coordinating a 
                uniform Federal message relating to prostate cancer 
                screening and treatment.
                    (B) Such representatives of the Department of 
                Defense as the Secretary of Defense considers 
                appropriate for such purpose.
                    (C) Such representatives of the Department of 
                Health and Human Services as the Secretary of Health 
                and Human Services considers appropriate for such 
                purpose, including representatives of the following:
                            (i) The National Institutes of Health.
                            (ii) National research institutes and 
                        centers, including the National Cancer 
                        Institute, the National Institute of Allergy 
                        and Infectious Diseases, and the Office of 
                        Minority Health.
                            (iii) The Centers for Medicare and Medicaid 
                        Services.
                            (iv) The Food and Drug Administration.
                            (v) The Centers for Disease Control and 
                        Prevention.
                            (vi) The Agency for Healthcare Research and 
                        Quality.
                            (vii) The Health Resources and Services 
                        Administration.
            (2) Meetings.--The Task Force shall meet at the call of the 
        Secretary of Veterans Affairs, but not less frequently than 
        twice each year.
    (c) Duties.--
            (1) Summary of advances in federal prostate cancer 
        research.--The Task Force shall develop a summary of advances 
        in prostate cancer research supported or conducted by Federal 
        agencies relevant to the diagnosis, prevention, and treatment 
        of prostate cancer.
            (2) List of best practices for treatment of prostate 
        cancer.--The Task Force shall develop a list of best practices 
        for treatment of prostate cancer that warrant broader adoption 
        in health care programs.
            (3) Share and coordinate.--The Task Force shall share and 
        coordinate information on existing Federal research and health 
        care program activities relating to prostate cancer, including 
        by carrying out the following with respect to such research and 
        health care program activities:
                    (A) Determining how to improve existing research 
                and health care programs.
                    (B) Identifying any gaps in the overall research 
                inventory and in health care programs.
                    (C) Identifying opportunities to promote 
                translation of research into practice.
                    (D) Maximizing the impact of existing efforts by 
                identifying opportunities for collaboration and 
                leveraging of resources in research and health care 
                programs that serve those susceptible to or diagnosed 
                with prostate cancer.
            (4) Comprehensive strategy and advice on solicitation of 
        proposals.--The Task Force shall develop a comprehensive 
        interagency strategy on, and advise relevant Federal agencies 
        in, the solicitation of proposals for collaborative, 
        multidisciplinary research and health care programs relating to 
        prostate cancer, including proposals to evaluate factors that 
        may be related to the etiology of prostate cancer, that would--
                    (A) result in innovative approaches to studying 
                emerging scientific opportunities or eliminating 
                knowledge gaps in research to improve the prostate 
                cancer research portfolio of the Federal Government;
                    (B) outline key research questions, methodologies, 
                and knowledge gaps;
                    (C) expand the number of research proposals and 
                health care programs that involve collaboration between 
                two or more Federal agencies, national research 
                institutes, or national centers, including proposals 
                for Common Fund research described in section 402(b)(7) 
                of the Public Health Service Act (42 U.S.C. 282(b)(7)) 
                to improve the prostate cancer research portfolio of 
                the Federal Government;
                    (D) expand the number of collaborative, 
                multidisciplinary, and multi-institutional research 
                grants relating to prostate cancer; and
                    (E) encourage such collaborations to include 
                coordination with other robust Federal and private 
                health care services research and health care programs 
                that have successfully addressed prostate cancer 
                education, outreach, and awareness among medically 
                underserved populations.
            (5) Coordinated message.--The Task Force shall develop a 
        coordinated message related to screening and treatment for 
        prostate cancer to be reflected in educational and beneficiary 
        materials for Federal health programs as such materials are 
        updated.
            (6) Recommendations and report.--
                    (A) In general.--Not later than two years after the 
                date of the establishment of the Task Force, the Task 
                Force shall submit to the Secretary of Veterans 
                Affairs, the Secretary of Defense, and the Secretary of 
                Health and Human Services a report on the matters 
                described in subparagraph (B).
                    (B) Matters.--The matters described in this 
                subparagraph are the following:
                            (i) Appropriate changes to research and 
                        health care programs of the Federal Government, 
                        including recommendations to improve the 
                        research portfolio of the Department of 
                        Veterans Affairs, Department of Defense, 
                        National Institutes of Health, and other 
                        Federal agencies, to ensure that scientifically 
                        based strategic planning is implemented in 
                        support of prostate cancer research and health 
                        care program priorities.
                            (ii) How to ensure that the prostate cancer 
                        research and health care program activities of 
                        the Department of Veterans Affairs, the 
                        Department of Defense, the National Institutes 
                        of Health, and other Federal agencies are free 
                        of unnecessary duplication.
                            (iii) How to improve public participation 
                        in decisions relating to prostate cancer 
                        research and health care programs to increase 
                        the involvement of patient advocacy, community 
                        organizations, and medical associations 
                        representing a broad geographical area.
                            (iv) How best to disseminate information on 
                        prostate cancer research and progress achieved 
                        by health care programs.
                            (v) How to expand partnerships between 
                        public entities, including Federal agencies, 
                        and private entities to encourage collaboration 
                        between such entities and agencies in prostate 
                        cancer research and health care delivery.
                            (vi) How to assess any cost savings and 
                        efficiencies realized through any activities 
                        identified or supported pursuant to this Act 
                        and recommending expansion of those activities 
                        that have proven most promising for the 
                        prevention, diagnosis, and treatment of 
                        prostate cancer.
                    (C) Elements.--The report required by subparagraph 
                (A) shall include the following:
                            (i) The recommendations of the Task Force 
                        on the matters described in subparagraph (B).
                            (ii) A prioritized ranking of the 
                        recommendations.
                            (iii) A description of the funding 
                        necessary to carry out each of the 
                        recommendations included in the report.
    (d) Appointing Expert Advisory Panels.--The Task Force shall 
appoint expert advisory panels to obtain input and concurrence from 
individuals and organizations from the medical, research, and health 
care delivery communities with expertise in prostate cancer diagnosis, 
treatment, and research, including practicing urologists, primary care 
providers, and individuals with expertise in education and outreach to 
medically underserved populations.

SEC. 5. PROSTATE CANCER RESEARCH.

    (a) Program Establishment.--The Secretary of Veterans Affairs 
shall, in coordination with the Secretary of Defense and the Secretary 
of Health and Human Services, establish and carry out a program to 
coordinate and intensify prostate cancer research.
    (b) Program Activities.--In carrying out the program required by 
subsection (a), the Secretary of Veterans Affairs shall--
            (1) carry out research to develop advances in improved 
        early detection, diagnostic, and prognostic methods and tests, 
        including--
                    (A) biomarkers and an improved prostate cancer 
                screening blood test; and
                    (B) improvements or alternatives to the prostate 
                specific antigen test and additional tests to 
                distinguish indolent from aggressive disease;
            (2) carry out research to better understand the etiology of 
        prostate cancer to improve prevention efforts, including an 
        analysis of--
                    (A) susceptibility and lifestyle factors proven to 
                be involved in higher rates of prostate cancer, such as 
                obesity and diet; and
                    (B) the role in which belonging to different 
                ethnic, racial, geographic, and socioeconomic groups, 
                such African-American, Latino, and American Indian 
                populations, as well as those living in rural and 
                highly rural areas, has on the incidence of prostate 
                cancer and mortality from prostate cancer;
            (3) expand basic research into prostate cancer, including 
        studies of fundamental molecular and cellular mechanisms;
            (4) identify and provide clinical testing of novel agents 
        for the prevention and treatment of prostate cancer;
            (5) establish clinical registries for prostate cancer; and
            (6) utilize the National Institute of Biomedical Imaging 
        and Bioengineering and the National Cancer Institute for 
        assessment of appropriate imaging services and technologies.
    (c) Matters Addressed.--In carrying out the program required by 
subsection (a), the Secretary shall address the following:
            (1) The racial, ethnic, and geographic disparities in the 
        incidence and mortality rates of prostate cancer.
            (2) The barriers, if any, regarding access to care and 
        participation in clinical trials that are specific to racial, 
        ethnic, and other underserved populations.
            (3) Such outreach and education as the Secretary considers 
        necessary to raise awareness of prostate cancer in the 
        communities of racial, ethnic, and other underserved 
        populations.
            (4) The availability of and utilization of appropriate 
        imaging services and technologies by racial, ethnic, and other 
        underserved populations.
    (d) Grants for Eligible Entities That Serve Medically Underserved 
Populations.--The Secretary shall carry out the program required by 
subsection (a) through the award of grants to entities that are 
eligible to apply for at least 1 grant under any Federal program.
    (e) Comparative Effectiveness Research.--In carrying out the 
program required by subsection (a), the Secretary shall integrate and 
build upon existing knowledge gained from comparative effectiveness 
research.

SEC. 6. INCORPORATION OF PROSTATE CANCER TREATMENT INTO FEDERAL 
              TELEHEALTH PROGRAMS.

    (a) In General.--Whenever practicable, the Secretary of Veterans 
Affairs, the Secretary of Defense, and the Secretary of Health and 
Human Services shall incorporate prostate cancer prevention, diagnosis, 
and treatment for medically underserved populations into the telehealth 
programs of the Department of Veterans Affairs, the Department of 
Defense, and the Department of Health and Human Services, respectively.
    (b) Populations.--In providing prostate cancer prevention, 
diagnosis, and treatment via telehealth programs under this section, 
the Secretary of Veterans Affairs, the Secretary of Defense, and the 
Secretary of Health and Human Services shall give priority to the 
provision of such prevention, diagnosis, and treatment to populations--
            (1) in medically underserved areas, particularly areas that 
        include populations consisting predominantly of Indians, Alaska 
        Natives, African-Americans, Hawaii Natives and other Pacific 
        Islanders, Asians, and Latinos; and
            (2) in rural and highly rural areas.
    (c) Delivery of Health Care.--In providing prostate cancer 
prevention, diagnosis, and treatment via telehealth programs under this 
section, the Secretary of Veterans Affairs, the Secretary of Defense, 
and the Secretary of Health and Human Services shall--
            (1) promote the efficient use of specialist care through 
        better coordination of primary care and physician extender 
        teams in medically underserved areas; and
            (2) more effectively employ tumor boards to better counsel 
        patients.
    (d) Evaluation.--In providing prostate cancer prevention, 
diagnosis, and treatment via telehealth programs under this section, 
the Secretary of Veterans Affairs, the Secretary of Defense, and the 
Secretary of Health and Human Services shall evaluate the following:
            (1) The effectiveness and efficiency of diagnosing and 
        treating prostate cancer using telehealth services in medically 
        underserved, rural, highly rural, and tribal areas, including 
        the use of tumor boards to facilitate better patient 
        counseling.
            (2) The collaborative uses of health care professionals and 
        the integration of a range of telehealth and other technologies 
        in the provision of health care in medically underserved 
        communities.
            (3) The effectiveness of improving the capacity of non-
        medical providers and non-specialized medical providers to 
        provide health care services for prostate cancer in medically 
        underserved, rural, highly rural, and tribal areas, including--
                    (A) the use of innovative medical home models with 
                collaboration between urologists and primary care 
                physicians; and
                    (B) coordination of care through the efficient use 
                of primary care physicians and physician extenders.
    (e) Report.--
            (1) In general.--Not later than five years after the date 
        of the enactment of this Act, the Secretary of Veterans 
        Affairs, the Secretary of Defense, and the Secretary of Health 
        and Human Services shall submit to Congress a report on their 
        activities under this section.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) A description of the outcomes of the activities 
                carried out under this section.
                    (B) An assessment of the effectiveness and 
                efficiency of using telehealth services to provide 
                health care in medically underserved communities.
                    (C) The recommendations, if any, of the Secretary 
                concerned as to whether the Federal Government should 
                increase the use of telehealth services to deliver 
                health care to medically underserved communities.
    (f) Definitions.--In this section:
            (1) Medical home model.--The term ``medical home model'' 
        means a model of care in which each patient has an ongoing 
        relationship with a personal physician who leads a health care 
        team that includes a specialist and takes collective 
        responsibility for patient care. Such team is responsible for 
        providing all the patient's health care needs and, when needed, 
        arranges for appropriate care with qualified physicians who are 
        not part of such team.
            (2) Physician extender.--The term ``physician extender'' 
        means a trained health care professional who provides quasi-
        autonomous health care under a particular physician's license. 
        Such term includes physician assistants and nurse 
        practitioners.
            (3) Primary care and physician extender team.--A ``primary 
        care and physician extender team'' is the collaboration of a 
        primary care physician and one or more physician extenders 
        working in collaboration with a urologist for the care of the 
        prostate cancer patient.
            (4) Telehealth.--The term ``telehealth'' means technology-
        based professional consultations, patient monitoring, patient 
        training services, clinical observation, assessment, or 
        treatment, and any additional services that utilize 
        technologies specified in the Healthcare Common Procedure 
        Coding System of the Centers for Medicare and Medicaid 
        Services.
            (5) Tumor board.--The term ``tumor board'' means a group of 
        physician experts in a particular disease or condition who 
        convene to discuss a particular case, normally one that is 
        challenging or complex, in order to drawn upon the collective 
        expertise of the group to reach consensus on a recommended 
        course of treatment.

SEC. 7. NATIONAL EDUCATION CAMPAIGN FOR PROSTATE CANCER AWARENESS.

    (a) National Education Campaign Required.--The Secretary of 
Veterans Affairs shall carry out a national education campaign to 
encourage men to seek prostate cancer prevention, diagnosis, and 
treatment when appropriate.
    (b) Manner.--The Secretary shall carry out the national education 
campaign required by subsection (a) through the development and 
distribution of educational materials and through public service 
announcements in a manner that is consistent with the findings and 
recommendations of the Interagency Prostate Cancer Coordination and 
Education Task Force established under section 4.
    (c) Availability of Educational Materials and Public Service 
Announcements in Communities With Higher Incidence of Prostate 
Cancer.--In carrying out the national education campaign required by 
subsection (a), the Secretary shall ensure that such educational 
materials and public service announcements required by subsection (b) 
are more readily available in communities with higher than average 
rates of incidence of prostate cancer and rates of mortality from 
prostate cancer.
    (d) Grants.--In carrying out the national education campaign 
required by subsection (a), the Secretary shall award grants to private 
nonprofit organizations to test alternative outreach and education 
strategies.

SEC. 8. DEFINITIONS.

    In this Act:
            (1) Highly rural.--The term ``highly rural'', with respect 
        to an area, means that the area consists of a county or 
        counties having a population density of less than seven persons 
        per square mile.
            (2) Rural.--The term ``rural'', with respect to an area, 
        means the area is a rural area as classified by the Director of 
        the Bureau of the Census.

SEC. 9. AUTHORIZATION OF APPROPRIATIONS.

    There is authorized to be appropriated to carry out this Act, such 
sums as necessary for each of fiscal years 2012 through 2016.
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