,i #aaith ,,congress #b;d ,session ,h4 ,r4 #heec ,,in ,,the ,,house ,,of ,,representatives ,april #bh1 #bjbf,mr4 ,murphy 7for himself and ,mr4 ,conaway7 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 precision oncology program for cancer of the prostate1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,precision ,oncology ,program for ,cancer of the ,prostate ,authorization ,act of #bjbf or the ,p,o,p,ca,p ,authorization ,act of #bjbf4 #b4 ,establishment of precision oncology program for cancer of the prostate 7a7 ,in general ,subchapter ,,ii of chapter #gc of title #ch1 ,united ,states ,code1 is amended by adding at the end the following new section3 #gccj;,e ,precision oncology program for cancer of the prostate 7a7 ,establishment ,the ,secretary shall establish a precision oncology program for cancer of the prostate 7in this section1 referred to as the ,program7 at the ,department in accordance with this section4 ,in carrying out the ,program1 the ,secretary shall-- 7#a7 shall designate ,centers of ,excellence in accordance with subsection 7d72 and 7#b7 maintain the ,program ,leadership team under subsection 7g74 7b7 ,eligibility ,a veteran is eligible to enroll in additional medical services through the ,program if such veteran is enrolled in the patient enrollment system under section #agje of this title and has a diagnosis of prostate cancer or non-prostate genitourinary cancer4 7c7 ,requirements of ,centers of ,excellence 7#a7 ,each ,center of ,excellence designated under this section shall carry out the following activities3 7,a7 ,establishing a program of genetic sequencing for veterans with advanced prostate cancer4 7,b7 ,implementing the uniform genetic sequencing platform developed by the ,program ,leadership under subsection 7g77#c77;,h7 to allow for coordination among ,centers4 7,c7 ,participating in the ,telemedicine ,tumor ,board of the ,program4 7,d7 ,participating in the prostate cancer registry maintained by the ,program ,leadership under subsection 7g77#c77;,e7 to track relevant genetic mutations4 7,e7 ,providing travel support to eligible veterans with such mutations to facilitate access to studies4 7,f7 ,developing biomarker-specific clinical trials4 7,g7 ,participating in industry-sponsored precision oncology studies4 7,h7 ,participating in monthly calls and not less than three in-person meetings per year with the ,program ,leadership to assess progress4 7,i7 ,providing ongoing reporting to the ,program ,leadership regarding trial accrual and research conducted by the ,center4 7,j7 ,establishing metastasis biopsy capability4 7,k7 ,extending resources to affiliated medical centers in the ,veterans ,integrated ,service ,network in which the ,center is located4 7#b7 ,the ,secretary shall ensure that each ,center designated under the ,program employs1 at a minimum-- 7,a7 a medical oncologist2 7,b7 an interventional radiologist2 7,c7 a urologist2 7,d7 a radiation oncologist2 7,e7 a pathologist2 and 7,f7 two full-time equivalent research staff members4 7d7 ,designation of ,centers of ,excellence 7#a7 ,the ,secretary may designate additional medical facilities as ,centers of ,excellence4 7#b7 ,the ,secretary shall ensure that not fewer than #ba medical facilities are designated as ,centers of ,excellence under this section at all times4 7#c7 ,the ,secretary shall ensure that at least one medical facility in each ,veterans ,integrated ,service ,network is designated as a ,center of ,excellence under this section4 7#d7 ,the ,secretary shall ensure that not fewer than seven of the ,centers of ,excellence designated under this section have a genitourinary program4 7#e7 ,effective on the date of the enactment of this section1 the following medical facilities shall be designated as ,centers of ,excellence for the ,program3 7,a7 ,the ,seattle ,,va ,medical ,center in ,seattle1 ,washington4 7,b7 ,the ,james ,j4 ,peters ,,va ,medical ,center in the ,bronx1 ,new ,york4 7,c7 ,the ,lieutenant ,colonel ,charles ,s4 ,kettles ,,va ,medical ,center in ,ann ,arbor1 ,michigan4 7,d7 ,the ,margaret ,cochran ,corbin ,manhattan ,,va ,medical ,center in ,manhattan1 ,new ,york4 7,e7 ,the ,jesse ,brown ,department of ,veterans ,affairs ,medical ,center in ,chicago1 ,illinois4 7,f7 ,the ,west ,los ,angeles ,,va ,medical ,center in ,los ,angeles1 ,california4 7,g7 ,the ,corporal ,michael ,j4 ,crescenz ,,va ,medical ,center in ,philadelphia1 ,pennsylvania4 7,h7 ,the ,durham ,,va ,medical ,center in ,durham1 ,north ,carolina4 7,i7 ,the ,washington ,,dc ,,va ,medical ,center in ,washington1 ,district of ,columbia4 7,j7 ,the ,james ,a4 ,haley ,veterans ,hospital in ,tampa1 ,florida4 7,k7 ,the ,portland ,,va ,medical ,center in ,portland1 ,oregon4 7,l7 ,the ,jamaica ,plain ,,va ,medical ,center in ,boston1 ,massachusetts4 7,m7 ,the ,san ,francisco ,,va ,medical ,center in ,san ,francisco1 ,california4 7,n7 ,the ,michael ,e4 ,de,bakey ,department of ,veterans ,affairs ,medical ,center in ,houston1 ,texas4 7,o7 ,the ,rocky ,mountain ,regional ,,va ,medical ,center in ,aurora1 ,colorado4 7,p7 ,the ,john ,j4 ,cochran ,veterans ,hospital in ,st4 ,louis1 ,missouri4 7,q7 ,the ,kansas ,city ,,va ,medical ,center in ,kansas ,city1 ,missouri4 7,r7 ,the ,joseph ,maxwell ,cleland ,atlanta ,,va ,medical ,center in ,decatur1 ,georgia4 7,s7 ,the ,ralph ,h4 ,johnson ,,va ,medical ,center in ,charleston1 ,south ,carolina4 7,t7 ,the ,orlando ,,va ,medical ,center in ,orlando1 ,florida4 7,u7 ,the ,baltimore ,,va ,medical ,center in ,baltimore1 ,maryland4 7,v7 ,the ,john ,l4 ,mc,clellan ,memorial ,veterans' ,hospital in ,little ,rock1 ,arkansas4 7,w7 ,the ,william ,s4 ,middleton ,memorial ,veterans ,hospital in ,madison1 ,wisconsin4 7,x7 ,the ,minneapolis ,,va ,medical ,center in ,minneapolis1 ,minnesota4 7,y7 ,the ,george ,e4 ,wahlen ,department of ,veterans ,affairs ,medical ,center in ,salt ,lake ,city1 ,utah4 7,z7 ,the ,carl ,t4 ,hayden ,veterans' ,administration ,medical ,center in ,phoenix1 ,arizona4 7,,aa7 ,the ,dallas ,,va ,medical ,center in ,dallas1 ,texas4 7,,bb7 ,the ,malcom ,randall ,department of ,veterans ,affairs ,medical ,center in ,gainesville1 ,florida4 7#f7 ,for purposes of complying with the minimum number of ,centers of ,excellence under paragraph 7#b71 the ,secretary shall count any towards the minimum number any medical facility designated under paragraph 7#e7 and not terminated under subsection 7e74 7e7 ,termination of ,designation 7#a7 ,each ,center of ,excellence designated under subsection 7d7 shall remain so designated for not less than five years1 unless the ,secretary terminates such designation in accordance with this subsection4 7#b7 ,not earlier than ,january #a1 #bjcj1 the ,secretary may terminate the designation of a medical facility as a ,center of ,excellence under this section if the ,secretary determines the facility is failing to meet the requirements in subsection 7c74 7#c7 ,before terminating the designation of a medical facility1 the ,secretary shall-- 7,a7 submit to the ,committees on ,veterans' ,affairs and the ,committees on ,appropriations of the ,house of ,representatives and the ,senate a notice of the intent to terminate such designation2 and 7,b7 wait for a period of #fj days following the date of the submission of such notice4 7f7 ,performance review 7#a7 ,in #bjcj and each year thereafter1 the ,secretary shall review the performance of not more than seven ,centers of ,excellence4 7#b7 ,the ,secretary shall ensure that the performance of each ,center of ,excellence is reviewed only once in a five year period4 7#c7 ,by the date of the submission of the annual report described in subsection 7f7 in #bjce and every fifth year thereafter1 the ,secretary shall ensure the performance of each ,center of ,excellence has been reviewed4 7#d7 ,each performance review under this subsection shall assess whether the performance of the ,center of ,excellence in providing the services required under subsection 7c7 is adequate to justify the continued designation of the facility as a ,center of ,excellence under this section4 7g7 ,program ,leadership team 7#a7 ,the ,secretary shall establish a ,program ,leadership team located at the ,seattle ,,va ,medical ,center in ,seattle1 ,washington1 which shall remain designated as a ,center of ,excellence until at least #bjcc4 7#b7 ,if the ,secretary terminates the designation of the ,seattle ,,va ,medical ,center in ,seattle1 ,washington1 as a ,center of ,excellence under subsection 7e71 the ,secretary shall select another ,center to serve as the location of the ,program ,leadership team4 7#c7 ,the ,program ,leadership team shall include1 at a minimum1 an ,executive ,director1 a ,clinical ,director1 and a ,research ,director1 who shall be employees of the medical center at which the ,program ,leadership team is located4 7#d7 ,the ,program ,leadership team shall-- 7,a7 provide strategic liaison services with sponsors and prospective sponsors of clinical trials to ensure engagement by the ,department with study design and participation2 7,b7 coordinate participation by the ,department in prostate cancer group studies sponsored by the ,national ,cancer ,institute2 7,c7 facilitate the development of study concepts1 designs1 and start-up with researchers of the ,department with limited clinical trial experience2 7,d7 create and execute a model for hybrid decentralized clinical trials to be used by ,centers of ,excellence when conducting trials1 including remote research coordination1 regulatory start-up and maintenance1 data management1 and ,institutional ,review ,board approval2 7,e7 create and maintain a publicly available prostate cancer registry and data repository of the ,department2 7,f7 establish and maintain relevant working groups of experts of the ,department2 7,g7 host at least monthly calls and at least three in-person meetings per year with a representative of each ,center for ,excellence to assess progress2 and 7,h7 develop a uniform genetic sequencing platform to be implemented by each ,center of ,excellence to allow for coordination among such ,centers4 7#e7 ,the ,executive ,director shall-- 7,a7 provide administrative leadership to the ,program in partnership with the ,clinical ,director2 7,b7 develop1 execute1 and monitor a national strategic plan for the ,program2 and 7,c7 serve as the liaison to leadership of the ,department and ,centers of ,excellence4 7#f7 ,the ,clinical ,director shall-- 7,a7 oversee the ,program to ensure eligible veterans receive access to care based on the latest research2 7,b7 develop and implement strategies for ,program growth1 quality improvement1 and patient satisfaction2 7,c7 serve on the review committee of the ,program for clinical trials conducted by ,centers of ,excellence to ensure studies are conducted ethically and efficiently2 and 7,d7 serve as the liaison with stakeholders to integrate clinical services and research4 7#g7 ,the ,research ,director shall-- 7,a7 provide leadership on national research objectives2 7,b7 serve on committees to review new research concepts and projects developed by ,centers of ,excellence2 7,c7 maintain an understanding of current research and emerging technologies in prostate cancer2 and 7,d7 interact with stakeholders1 including regulatory agencies1 study sponsors1 and research institutions1 to improve prostate cancer research conducted by the ,department4 7h7 ,annual ,report 7#a7 ,not later than ,march #a of each year1 the ,secretary shall submit to the ,committees on ,veterans' ,affairs and the ,committees on ,appropriations of the ,house of ,representatives and the ,senate a report on the ,program4 ,each such report shall include1 for the year covered by the report-- 7,a7 the funding levels for each ,center of ,excellence2 7,b7 the number of veterans participating the ,program2 7,c7 the number of researchers and providers participating in the ,program2 7,d7 the number of publications relating to prostate cancer by researchers and providers of the ,department2 7,e7 the number of clinical research studies supported by the ,program2 7,f7 the number of veterans enrolled in such clinical research studies2 7,g7 the five-year survival rate of veterans enrolled in clinical research studies of the ,program compared to other veterans and civilians with prostate cancer2 7,h7 the five-year survival rate of veterans with non-prostate genitourinary cancers enrolled in clinical research studies of the ,program at genitourinary centers compared to that of other veterans and civilians with non-prostate genitourinary cancers2 and 7,i7 an estimate of 7,a7 through 7,g7 for the upcoming year4 7#b7 ,in #bjbi1 the report required in this subsection shall include a comprehensive plan for the designation and operation of the ,centers of ,excellence under this section1 including a timeline for the performance evaluations1 performance criteria to be used in evaluations1 and the process for selecting ,centers4 7#c7 ,in #bjca and each year thereafter1 the report required in this subsection shall include1 for the year covered by the report1 the results of the performance reviews conducted under subsection 7f7 and a determination by the ,secretary regarding whether each ,center of ,excellence reviewed that year meets the criteria for continued designation as a ,center of ,excellence4 7i7 ,authorization of appropriations ,there is authorized to be appropriated #ae1ejj1jjj for each of fiscal years #bjbg through #bjbi to the ,secretary to carry out this section4 4 7b7 ,clerical amendment ,the table of sections at the beginning of such chapter is amended by inserting after the item relating to section #gccj;,d the following new item3 #gccj;,e4 ,precision oncology program for cancer of the prostate4 4 7c7 ,functions and funding of ,centers of ,excellence 7#a7 ,functions ,the ,secretary of ,veterans ,affairs may not remove from any medical facility designated as a ,center of ,excellence under section #gccj;,d of title #ch1 ,united ,states ,code1 any staff1 program1 or function relating to prostate cancer that was in effect on ,january #a1 #bjbc1 until ,january #a1 #bjcj4 7#b7 ,funding ,the ,secretary of ,veterans ,affairs may not reduce funding provided to such ,centers of ,excellence below the total amount provided by public and private sources in effect on ,january #a1 #bjbc1 until ,january #a1 #bjcj4 7d7 ,deadline ,the program required by section #gccj;,e of title #ch1 ,united ,states ,code1 as added by subsection 7a71 shall be established by not later than #ahj days after the date of the enactment of this ,act4 #c4 ,implementation plan ,not later than #fj days after the date of the enactment of this ,act1 the ,secretary of ,veterans ,affairs shall submit to the ,committees on ,veterans' ,affairs of the ,senate and the ,house of ,representatives a plan for the implementation of section #gccj;,e of title #ch1 ,united ,states ,code1 as added by section #b4 ,such plan shall include-- 7#a7 a description of staffing requirements at each ,center of ,excellence designated under such section2 7#b7 a description of any contracting requirements necessary to fulfill the requirements of such section2 7#c7 a plan for the development of the uniform sequencing platform required under subsection 7g77#c77;,h7 of such section2 7#d7 a description of the development of the prostate cancer registry and data repository under subsection 7g77#c77;,e7 of such section2 7#e7 a plan for coordination with the ,central ,institutional ,review ,board2 and 7#f7 a description of anticipated funding levels for the ten-year period beginning on the date of the submission of the plan4