[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4880 Introduced in House (IH)]
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117th CONGRESS
1st Session
H. R. 4880
To direct the Secretary of Veterans Affairs to establish a national
clinical pathway for prostate cancer, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 30, 2021
Mr. Dunn (for himself, Ms. Slotkin, Mr. Allred, and Mr. Murphy of North
Carolina) introduced the following bill; which was referred to the
Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To direct the Secretary of Veterans Affairs to establish a national
clinical pathway for prostate cancer, 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 ``Veterans' Prostate Cancer Treatment
and Research Act''.
SEC. 2. FINDINGS.
Congress makes the following findings:
(1) Prostate cancer is the number one cancer diagnosed in
the Veterans Health Administration.
(2) A 1996 report published by the National Academy of
Sciences, Engineering, and Medicine established a link between
prostate cancer and exposure to herbicides, such as Agent
Orange.
(3) It is essential to acknowledge that due to these
circumstances, certain veterans are made aware that they are
high-risk individuals when it comes to the potential to develop
prostate cancer.
(4) In being designated as ``high risk'', it is essential
that veterans are proactive in seeking earlier preventative
clinical services for the early detection and successful
treatment of prostate cancer, whether that be through the
Veterans Health Administration or through a community provider.
(5) Clinical preventative services and initial detection
are some of the most important components in the early
detection of prostate cancer for veterans at high risk of
prostate cancer.
(6) For veterans with prostate cancer, including prostate
cancer that has metastasized, precision oncology, including
biomarker-driven clinical trials and innovations underway
through the Prostate Cancer Foundation and Department of
Veterans Affairs partnership, represents one of the most
promising areas of interventions, treatments, and cures for
such veterans and their families.
SEC. 3. DEPARTMENT OF VETERANS AFFAIRS TREATMENT AND RESEARCH OF
PROSTATE CANCER.
(a) Establishment of Clinical Pathway.--
(1) In general.--Not later than 365 days after the date of
the enactment of this Act, the Secretary of Veterans Affairs
shall establish an interdisciplinary clinical pathway for all
stages of prostate cancer, from early detection to end of life
care. The clinical pathway shall be established in the National
Surgery Office of the Department of Veterans Affairs in close
collaboration with the National Program Office of Oncology, the
Office of Research and Development, and other relevant entities
of the Department, including Primary Care.
(2) Elements.--The national clinical pathway established
under this subsection shall include the following elements:
(A) A diagnosis pathway for prostate cancer that
includes early screening and diagnosis protocol,
including screening recommendations for veterans with
evidence-based risk factors.
(B) A treatment pathway that details the respective
roles of each office of the Department that will
interact with veterans receiving prostate cancer care,
including treatment protocol recommendations for
veterans with evidence-based risk factors.
(C) Treatment recommendations for all stages of
prostate cancer that reflect nationally recognized
standards for oncology, including National
Comprehensive Cancer Network guidelines.
(D) A suggested protocol timeframe for each point
of care, from early screening to treatment and end-of-
life care, based on severity and stage of cancer.
(E) A plan that includes, as appropriate, both
Department medical facilities and community-based
partners and providers and research centers
specializing in prostate cancer, especially such
centers that have entered into partnerships with the
Department.
(3) Collaboration and coordination.--In establishing the
clinical pathway required under this section, the Secretary may
collaborate and coordinate with--
(A) the National Institutes of Health;
(B) the National Cancer Institute;
(C) the National Institute on Minority Health and
Health Disparities;
(D) the Centers for Disease Control and Prevention;
(E) the Centers for Medicare and Medicaid Services;
(F) the Patient-Centered Outcomes Research
Institute;
(G) the Food and Drug Administration;
(H) the Department of Defense; and
(I) other Institutes and Centers as the Secretary
determines necessary.
(4) Consultation requirement.--In establishing the clinical
pathway required under this section, the Secretary shall
consult with, and incorporate feedback from, veterans who have
received prostate cancer care at Department medical facilities
as well as experts in multi-disciplinary cancer care and
clinical research.
(5) Publication.--The Secretary shall--
(A) publish the clinical pathway established under
this subsection on a publicly available Department
website; and
(B) update the clinical pathway as needed by review
of the medical literature and available evidence-based
guidelines at least annually, in accordance with the
criteria under paragraph (2).
(b) Development of Comprehensive Prostate Cancer Program and
Implementation of the Prostate Cancer Clinical Pathway.--
(1) Establishment.--Not later than 180 days after the date
of the enactment of this Act, the Secretary shall submit to
Congress a plan to establish a prostate cancer program using
the comprehensive prostate cancer clinical pathway developed
under subsection (a).
(2) Program requirements.--The comprehensive prostate
cancer program shall--
(A) receive direct oversight from the Deputy
Undersecretary for Health of the Department of Veterans
Affairs;
(B) include a yearly program implementation
evaluation to facilitate replication for other disease
states or in other healthcare institutions;
(C) be metric driven and include the development of
biannual reports on the quality of prostate cancer
care, which shall be provided to the leadership of the
Department, medical centers, and providers and made
publicly available in an electronic form; and
(D) include an education plan for patients and
providers.
(3) Program implementation evaluation.--The Secretary shall
establish a program evaluation tool to learn best practices and
to inform the Department and Congress regarding further use of
the disease specific model of care delivery.
(4) Prostate cancer research.--The Secretary shall submit
to Congress a plan that provides for continual funding through
the Office of Research and Development of the Department of
Veterans for supporting prostate cancer research designed to
position the Department as a national resource for prostate
cancer detection and treatment. Such plan shall--
(A) include details regarding the funding of and
coordination between the National Precision Oncology
Program of the Department and the PCF-VA Precision
Oncology Centers of Excellence as related to the
requirements of this Act; and
(B) affirm that no funding included in such funding
plan is duplicative in nature.
(c) Report on National Registry.--The Secretary of Veterans Affairs
shall submit to Congress a report on the barriers and challenges
associated with creating a national prostate cancer registry. Such
report shall include recommendations for centralizing data about
veterans with prostate cancer for the purpose of improving outcomes and
serving as a resource for providers.
(d) Definitions.--In this section:
(1) The term ``clinical pathway'' means a health care
management tool designed around research and evidence-backed
practices that provides direction for the clinical care and
treatment of a specific episode of a condition or ailment.
(2) The term ``evidence-based risk factors'' includes race,
ethnicity, socioeconomic status, geographic location, exposure
risks, genetic risks, including family history, and such other
factors as the Secretary determines appropriate.
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