1.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
.
2.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.
3.Sense of
Congress on access to and provision and coordination of health care for
diagnosis and treatment of prostate cancerIt 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.
4.Interagency
Prostate Cancer Coordination and Education Task Force
(a)
(1)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)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)
(1)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)The
Task Force shall meet at the call of the Secretary of Veterans Affairs, but not
less frequently than twice each year.
(c)
(1)Summary of
advances in Federal prostate cancer researchThe 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 cancerThe Task Force shall
develop a list of best practices for treatment of prostate cancer that warrant
broader adoption in health care programs.
(3)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 proposalsThe 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)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)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)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)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 panelsThe 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.
5.
(a)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)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)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
populationsThe 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 researchIn carrying out the program required by
subsection (a), the Secretary shall integrate and build upon existing knowledge
gained from comparative effectiveness research.
6.Incorporation of
prostate cancer treatment into Federal telehealth programs
(a)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)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)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)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)
(1)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)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)In
this section:
(1)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)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 teamA 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)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)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.
7.National
education campaign for prostate cancer awareness
(a)National
education campaign requiredThe 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)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 cancerIn 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)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.
8.In this Act:
(1)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)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.
9.Authorization of
appropriationsThere is
authorized to be appropriated to carry out this Act, such sums as necessary for
each of fiscal years 2012 through 2016.