,i #aagth ,,congress #ast ,session ,h4 ,r4 #dhhj ,,in ,,the ,,house ,,of ,,representatives ,july #cj1 #bjba,mr4 ,dunn 7for himself1 ,ms4 ,slotkin1 ,mr4 ,allred1 and ,mr4 ,murphy of ,north ,carolina7 introduced the following bill2 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 cancer1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,veterans' ,prostate ,cancer ,treatment and ,research ,act4 #b4 ,findings ,congress makes the following findings3 7#a7 ,prostate cancer is the number one cancer diagnosed in the ,veterans ,health ,administration4 7#b7 ,a #aiif report published by the ,national ,academy of ,sciences1 ,engineering1 and ,medicine established a link between prostate cancer and exposure to herbicides1 such as ,agent ,orange4 7#c7 ,it is essential to acknowledge that due to these circumstances1 certain veterans are made aware that they are high-risk individuals when it comes to the potential to develop prostate cancer4 7#d7 ,in being designated as high risk1 it is essential that veterans are proactive in seeking earlier preventative clinical services for the early detection and successful treatment of prostate cancer1 whether that be through the ,veterans ,health ,administration or through a community provider4 7#e7 ,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 cancer4 7#f7 ,for veterans with prostate cancer1 including prostate cancer that has metastasized1 precision oncology1 including biomarker-driven clinical trials and innovations underway through the ,prostate ,cancer ,foundation and ,department of ,veterans ,affairs partnership1 represents one of the most promising areas of interventions1 treatments1 and cures for such veterans and their families4 #c4 ,department of ,veterans ,affairs treatment and research of prostate cancer 7a7 ,establishment of clinical pathway 7#a7 ,in general ,not later than #cfe days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall establish an interdisciplinary clinical pathway for all stages of prostate cancer1 from early detection to end of life care4 ,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 ,oncology1 the ,office of ,research and ,development1 and other relevant entities of the ,department1 including ,primary ,care4 7#b7 ,elements ,the national clinical pathway established under this subsection shall include the following elements3 7,a7 ,a diagnosis pathway for prostate cancer that includes early screening and diagnosis protocol1 including screening recommendations for veterans with evidence-based risk factors4 7,b7 ,a treatment pathway that details the respective roles of each office of the ,department that will interact with veterans receiving prostate cancer care1 including treatment protocol recommendations for veterans with evidence-based risk factors4 7,c7 ,treatment recommendations for all stages of prostate cancer that reflect nationally recognized standards for oncology1 including ,national ,comprehensive ,cancer ,network guidelines4 7,d7 ,a suggested protocol timeframe for each point of care1 from early screening to treatment and end-of-life care1 based on severity and stage of cancer4 7,e7 ,a plan that includes1 as appropriate1 both ,department medical facilities and community-based partners and providers and research centers specializing in prostate cancer1 especially such centers that have entered into partnerships with the ,department4 7#c7 ,collaboration and coordination ,in establishing the clinical pathway required under this section1 the ,secretary may collaborate and coordinate with-- 7,a7 the ,national ,institutes of ,health2 7,b7 the ,national ,cancer ,institute2 7,c7 the ,national ,institute on ,minority ,health and ,health ,disparities2 7,d7 the ,centers for ,disease ,control and ,prevention2 7,e7 the ,centers for ,medicare and ,medicaid ,services2 7,f7 the ,patient-,centered ,outcomes ,research ,institute2 7,g7 the ,food and ,drug ,administration2 7,h7 the ,department of ,defense2 and 7,i7 other ,institutes and ,centers as the ,secretary determines necessary4 7#d7 ,consultation requirement ,in establishing the clinical pathway required under this section1 the ,secretary shall consult with1 and incorporate feedback from1 veterans who have received prostate cancer care at ,department medical facilities as well as experts in multi-disciplinary cancer care and clinical research4 7#e7 ,publication ,the ,secretary shall-- 7,a7 publish the clinical pathway established under this subsection on a publicly available ,department website2 and 7,b7 update the clinical pathway as needed by review of the medical literature and available evidence-based guidelines at least annually1 in accordance with the criteria under paragraph 7#b74 7b7 ,development of ,comprehensive ,prostate ,cancer ,program and ,implementation of the ,prostate ,cancer ,clinical ,pathway 7#a7 ,establishment ,not later than #ahj days after the date of the enactment of this ,act1 the ,secretary shall submit to ,congress a plan to establish a prostate cancer program using the comprehensive prostate cancer clinical pathway developed under subsection 7a74 7#b7 ,program requirements ,the comprehensive prostate cancer program shall-- 7,a7 receive direct oversight from the ,deputy ,undersecretary for ,health of the ,department of ,veterans ,affairs2 7,b7 include a yearly program implementation evaluation to facilitate replication for other disease states or in other healthcare institutions2 7,c7 be metric driven and include the development of biannual reports on the quality of prostate cancer care1 which shall be provided to the leadership of the ,department1 medical centers1 and providers and made publicly available in an electronic form2 and 7,d7 include an education plan for patients and providers4 7#c7 ,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 delivery4 7#d7 ,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 treatment4 ,such plan shall-- 7,a7 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 ,act2 and 7,b7 affirm that no funding included in such funding plan is duplicative in nature4 7c7 ,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 registry4 ,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 providers4 7d7 ,definitions ,in this section3 7#a7 ,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 ailment4 7#b7 ,the term evidence-based risk factors includes race1 ethnicity1 socioeconomic status1 geographic location1 exposure risks1 genetic risks1 including family history1 and such other factors as the ,secretary determines appropriate4