[Congressional Record Volume 166, Number 164 (Tuesday, September 22, 2020)]
[House]
[Pages H4684-H4685]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          VETERAN'S PROSTATE CANCER TREATMENT AND RESEARCH ACT

  Mr. TAKANO. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 6092) to direct the Secretary of Veterans Affairs to 
establish a national clinical pathway for prostate cancer, access to 
life-saving extending precision clinical trials and research, and for 
other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 6092

       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 ``Veteran's 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 in the National Surgery Office of the 
     Department of Veterans Affairs a national clinical pathway 
     for all stages of prostate cancer, from early detection to 
     end-of-life care including recommendations regarding the use 
     of transformative innovations, research, and uniform clinical 
     data.
       (2) Elements.--The national clinical pathway established 
     under this subsection shall include the following elements:
       (A) A multi-disciplinary plan for the early detection, 
     diagnosis, and treatment of prostate cancer 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.
       (B) A suggested, but not mandatory, protocol for screening, 
     diagnosis, and treatment or care for subpopulations with 
     evidence-based risk factors (including race, ethnicity, 
     socioeconomic status, geographic location, exposure risks, 
     and genetic risks, including family history).
       (C) A suggested treatment protocol timeframe for each point 
     of care based on severity and stage of cancer.
       (3) Public comment period.--Upon the establishment of a 
     proposed clinical pathway as required under this subsection, 
     the Secretary shall publish the proposed clinical pathway in 
     the Federal Register and provide for a 45-day period for 
     public comments. The Secretary--
       (A) may make any such public comments publicly available; 
     and
       (B) make changes to the proposed clinical pathway in 
     response to any such comments received using the same process 
     and criteria used to establish the proposed clinical pathway.
       (4) Collaboration and coordination.--In establishing the 
     clinical pathway required under this section, the Secretary 
     shall--
       (A) provide for consideration of other clinical pathways 
     and research findings of other departments and agencies, 
     including guidelines that are widely recognized and 
     guidelines that are used as the standard for clinical policy 
     in oncology care, such as National Comprehensive Cancer 
     Network guidelines; and
       (B) collaborate and coordinate with--
       (i) the National Institutes of Health;
       (ii) the National Cancer Institute;
       (iii) the National Institute on Minority Health and Health 
     Disparities;
       (iv) other Institutes and Centers as the Secretary 
     determines necessary;
       (v) the Centers for Disease Control and Prevention;
       (vi) the Department of Defense;
       (vii) the Centers for Medicare and Medicaid Services;
       (viii) the Patient-Centered Outcomes Research Institute; 
     and
       (ix) the Food and Drug Administration.
       (5) Publication.--The Secretary shall--
       (A) publish the clinical pathway established under this 
     subsection on a publicly available Department website; and
       (B) regularly 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 National Cancer of the Prostate Clinical 
     Care Implementation Program.--
       (1) Establishment.--Not later than 90 days after the date 
     of the enactment of this Act, the Secretary shall submit to 
     Congress a plan to establish a comprehensive prostate cancer 
     program.
       (2) Program requirements.--The comprehensive prostate 
     cancer program shall--
       (A) be multidisciplinary and include the authority to work 
     across clinical care lines, specialties, and the 
     organizational divisions of the Veterans Health 
     Administration;
       (B) receive direct oversight from the Deputy Undersecretary 
     for Health of the Department of Veterans Affairs;
       (C) include a yearly program implementation evaluation to 
     facilitate replication for other disease states or in other 
     healthcare institutions;
       (D) be metric driven and include the development of 
     quarterly 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;
       (E) made available as national decision support tools in 
     the electronic medical record; and

[[Page H4685]]

       (F) include an education plan for patients and providers.
       (3) Program implementation evaluation.--The Secretary shall 
     establish a program evaluation tool as an integral component 
     to learn best practices of multidisciplinary disease-based 
     implementation 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 Affairs for supporting prostate cancer 
     research designed to position the Department as a national 
     resource for quality reporting metrics, practice-based 
     evidence, comparative effectiveness, precision oncology, and 
     clinical trials in prostate cancer.
       (5) Prostate cancer real time registry program.--The 
     Secretary, in collaboration with data stewards of the 
     Department of Veterans Affairs, scientists, and the heads of 
     other Departments, agencies, and non-governmental 
     organizations, such as foundations and non-profit 
     organizations focused on prostate cancer research and care, 
     shall establish a real-time, actionable, national prostate 
     cancer registry. Such registry shall be designed--
       (A) to establish a systematic and standardized database 
     that enables intra-agency collaboration by which to track 
     veteran patient progress, enable population management 
     programs, facilitate best outcomes, and encourage future 
     research and further development of clinical pathways, 
     including patient access to precision resources and 
     treatments and access to life-extending precision clinical 
     trials;
       (B) to employ novel methods of structuring data, including 
     natural language processing, artificial intelligence, 
     structured data clinical notes, patient reported outcome 
     instruments, and other tools, to ensure that all clinically 
     meaningful data is included; and
       (C) to be accessible to--
       (i) clinicians treating veterans diagnosed with prostate 
     cancer and being treated for prostate cancer in conjunction 
     with Department medical facilities; and
       (ii) researchers.
       (c) Clinical Pathway Defined.--In this section, 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.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Takano) and the gentleman from Tennessee (Mr. David P. 
Roe) each will control 20 minutes.
  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. TAKANO. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days in which to revise and extend their remarks and 
to include extraneous material on H.R. 6092, as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. TAKANO. Mr. Speaker, I yield back the balance of my time.
  Mr. DAVID P. ROE of Tennessee. Mr. Speaker, I yield back the balance 
of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Takano) that the House suspend the rules 
and pass the bill, H.R. 6092, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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