,,ii  #aag? ,,congress  #a/ ,session    
,s4 #bgbj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #ac1         
#bjba,mr4 ,moran 7= himself & ,mr4      
,te/]7 introduc$ ! foll[+ bill2 :i* 0   
read twice & ref]r$ to ! ,committee on  
,vet]ans' ,affairs  ,a ,,bill  ,to      
direct ! ,secret>y ( ,vet]ans ,affairs  
to e/abli% a national cl9ical pa?way =  
pro/ate canc]1 & = o!r purposes4  #a4   
,%ort title ,?is ,act may be cit$ z !   
,vet]ans' ,pro/ate ,canc] ,treatm5t &   
,rese>* ,act4  #b4 ,f9d+s ,congress     
makes ! foll[+ f9d+s3 7#a7 ,pro/ate     
canc] is ! numb] "o canc] diagnos$ 9 !  
,vet]ans ,heal? ,adm9i/ration4  7#b7 ,a 
#aiif report publi%$ by ! ,national     
,academy ( ,sci5ces1 ,eng9e]+1 & ,m$ic9e
 e/abli%$ a l9k betwe5 pro/ate canc] &  
exposure to h]bicides1 su* z ,ag5t      
,orange4  7#c7 ,x is ess5tial to        
ackn[l$ge t due to ^! circum/ances1     
c]ta9 vet]ans are made aw>e t !y are    
high-risk individuals :5 x comes to !   
pot5tial to develop pro/ate canc]4  7#d7

 ,9 be+ designat$ z high risk1 x is     
ess5tial t vet]ans are proactive 9 seek+
 e>li] prev5tative cl9ical s]vices = !  
e>ly detection & successful treatm5t (  
pro/ate canc]1 :e!r t be ?r\gh !        
,vet]ans ,heal? ,adm9i/ration or ?r\gh a
 community provid]4  7#e7 ,cl9ical      
prev5tative s]vices & initial detection 
are "s ( ! mo/ important compon5ts 9 !  
e>ly detection ( pro/ate canc] = vet]ans
 at high risk ( pro/ate canc]4  7#f7 ,= 
vet]ans ) pro/ate canc]1 includ+ pro/ate
 canc] t has meta/asiz$1 precision      
oncology1 includ+ biom>k]-driv5 cl9ical 
trials & innovations und]way ?r\gh !    
,pro/ate ,canc] ,f\ndation & ,dep>tm5t (
 ,vet]ans ,affairs p>tn]%ip1 repres5ts  
"o ( ! mo/ promis+ areas ( int]v5tions1 
treatm5ts1 & cures = su* vet]ans & _!   
families4  #c4 ,dep>tm5t ( ,vet]ans     
,affairs treatm5t & rese>* ( pro/ate    
canc]  7a7 ,e/abli%m5t ( cl9ical pa?way 
7#a7 ,9 g5]al ,n lat] ?an #cfe days aft]
 ! date ( ! enactm5t ( ?is ,act1 !      
,secret>y ( ,vet]ans ,affairs %all      

e/abli% an int]discipl9>y cl9ical pa?way
 = all /ages ( pro/ate canc]1 f e>ly    
detection to end ( life c>e4 ,! cl9ical 
pa?way %all be e/abli%$ 9 ! ,national   
,surg]y ,(fice ( ! ,dep>tm5t ( ,vet]ans 
,affairs 9 close collaboration ) !      
,national ,program ,(fice ( ,oncology1 !
 ,(fice ( ,rese>* & ,developm5t1 & o!r  
relevant entities ( ! ,dep>tm5t1 includ+
 ,prim>y ,c>e4  7#b7 ,elem5ts ,!        
national cl9ical pa?way e/abli%$ "u ?is 
subsection %all include ! foll[+        
elem5ts3 7,a7 ,a diagnosis pa?way =     
pro/ate canc] t includes e>ly scre5+ &  
diagnosis protocol1 includ+ scre5+      
recomm5dations = vet]ans ) evid5ce-bas$ 
risk factors4  7,b7 ,a treatm5t pa?way t
 details ! respective roles ( ea* (fice 
( ! ,dep>tm5t t w int]act ) vet]ans     
receiv+ pro/ate canc] c>e1 includ+      
treatm5t protocol recomm5dations =      
vet]ans ) evid5ce-bas$ risk factors4    
7,c7 ,treatm5t recomm5dations = all     
/ages ( pro/ate canc] t reflect         
nationally recogniz$ /&>ds = oncology1  

includ+ ,national ,compreh5sive ,canc]  
,network guidel9es4  7,d7 ,a sugge/$    
protocol timeframe = ea* po9t ( c>e1 f  
e>ly scre5+ to treatm5t & end-(-life    
c>e1 bas$ on sev]ity & /age ( canc]4    
7,e7 ,a plan t includes1 z appropriate1 
bo? ,dep>tm5t m$ical facilities &       
community-bas$ p>tn]s & provid]s &      
rese>* c5t]s specializ+ 9 pro/ate canc]1
 especially su* c5t]s t h ent]$ into    
p>tn]%ips ) ! ,dep>tm5t4  7#c7          
,collaboration & coord9ation ,9 e/abli%+
 ! cl9ical pa?way requir$ "u ?is        
section1 ! ,secret>y may collaborate &  
coord9ate )-- 7,a7 ! ,national          
,in/itutes ( ,heal?2  7,b7 ! ,national  
,canc] ,in/itute2  7,c7 ! ,national     
,in/itute on ,m9ority ,heal? & ,heal?   
,disp>ities2  7,d7 ! ,c5t]s = ,disease  
,control & ,prev5tion2  7,e7 ! ,c5t]s = 
,m$ic>e & ,m$icaid ,s]vices2  7,f7 !    
,pati5t-,c5t]$ ,outcomes ,rese>*        
,in/itute2  7,g7 ! ,food & ,drug        
,adm9i/ration2  7,h7 ! ,dep>tm5t (      
,def5se2 &  7,i7 o!r ,in/itutes & ,c5t]s

 z ! ,secret>y det]m9es necess>y4  7#d7 
,consultation requirem5t ,9 e/abli%+ !  
cl9ical pa?way requir$ "u ?is section1 !
 ,secret>y %all consult )1 & incorporate
 fe$back f1 vet]ans :o h receiv$ pro/ate
 canc] c>e at ,dep>tm5t m$ical          
facilities z well z exp]ts 9            
multi-discipl9>y canc] c>e & cl9ical    
rese>*4  7#e7 ,publication ,! ,secret>y 
%all-- 7,a7 publi% ! cl9ical pa?way     
e/abli%$ "u ?is subsection on a publicly
 available ,dep>tm5t website2 &  7,b7   
update ! cl9ical pa?way z ne$$ by review
 ( ! m$ical lit]ature & available       
evid5ce-bas$ guidel9es at lea/ annually1
 9 accordance ) ! crit]ia "u p>agraph   
7#b74  7b7 ,developm5t ( ,compreh5sive  
,pro/ate ,canc] ,program &              
,implem5tation ( ! ,pro/ate ,canc]      
,cl9ical ,pa?way  7#a7 ,e/abli%m5t ,n   
lat] ?an #ahj days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y %all   
submit to ,congress a plan to e/abli% a 
pro/ate canc] program us+ ! compreh5sive
 pro/ate canc] cl9ical pa?way develop$  

"u subsection 7a74  7#b7 ,program       
requirem5ts ,! compreh5sive pro/ate     
canc] program %all-- 7,a7 receive direct
 ov]sight f ! ,deputy ,und]secret>y =   
,heal? ( ! ,dep>tm5t ( ,vet]ans         
,affairs2  7,b7 include a ye>ly program 
implem5tation evaluation to facilitate  
replication = o!r disease /ates or 9 o!r
 heal?c>e in/itutions2  7,c7 be metric  
driv5 & include ! developm5t ( biannual 
reports on ! quality ( pro/ate canc]    
c>e1 :i* %all be provid$ to ! lead]%ip (
 ! ,dep>tm5t1 m$ical c5t]s1 & provid]s &
 made publicly available 9 an electronic
 =m2 &  7,d7 include an education plan =
 pati5ts & provid]s4  7#c7 ,program     
implem5tation evaluation ,! ,secret>y   
%all e/abli% a program evaluation tool  
to le>n be/ practices & to in=m !       
,dep>tm5t & ,congress reg>d+ fur!r use (
 ! disease specific model ( c>e deliv]y4
  7#d7 ,pro/ate canc] rese>* ,!         
,secret>y %all submit to ,congress a    
plan t provides = cont9ual fund+ ?r\gh !
 ,(fice ( ,rese>* & ,developm5t ( !     

,dep>tm5t ( ,vet]ans = support+ pro/ate 
canc] rese>* design$ to position !      
,dep>tm5t z a national res\rce = pro/ate
 canc] detection & treatm5t4 ,su* plan  
%all-- 7,a7 include details reg>d+ !    
fund+ ( & coord9ation betwe5 ! ,national
 ,precision ,oncology ,program ( !      
,dep>tm5t & ! ,,pcf-,,va ,precision     
,oncology ,c5t]s ( ,excell5ce z relat$  
to ! requirem5ts ( ?is ,act2 &  7,b7    
affirm t no fund+ includ$ 9 su* fund+   
plan is duplicative 9 nature4  7c7      
,report on national regi/ry ,! ,secret>y
 ( ,vet]ans ,affairs %all submit to     
,congress a report on ! b>ri]s &        
*all5ges associat$ ) creat+ a national  
pro/ate canc] regi/ry4 ,su* report %all 
include recomm5dations = c5traliz+ data 
ab\t vet]ans ) pro/ate canc] = ! purpose
 ( improv+ outcomes & s]v+ z a res\rce =
 provid]s4  7d7 ,def9itions ,9 ?is      
section3 7#a7 ,! t]m cl9ical pa?way     
means a heal? c>e managem5t tool design$
 ar\nd rese>* & evid5ce-back$ practices 
t provides direction = ! cl9ical c>e &  

treatm5t ( a specific episode ( a       
condition or ailm5t4  7#b7 ,! t]m       
evid5ce-bas$ risk factors includes race1
 e?nicity1 socioeconomic /atus1         
geographic location1 exposure risks1    
g5etic risks1 includ+ family hi/ory1 &  
su* o!r factors z ! ,secret>y det]m9es  
appropriate4