[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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