,,ii  #aai? ,,congress  #b;d ,session   
,s4 #diic  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,july #ae1 #bjbf,mr4   
,moran 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 precision oncology program 
= canc] ( ! pro/ate at ! ,dep>tm5t (    
,vet]ans ,affairs1 & = o!r purposes4    
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,precision ,oncology ,program = ,canc]
 ( ! ,pro/ate ,au?orization ,act ( #bjbf
 or ! ,p,o,p,ca,p ,act ( #bjbf4  #b4    
,e/abli%m5t ( precision oncology program
 = canc] ( ! pro/ate  7a7 ,e/abli%m5t ( 
program  7#a7 ,9 g5]al ,sub*apt] ,,ii ( 
*apt] #gc ( title #ch1 ,unit$ ,/ates    
,code1 is am5d$ by add+ at ! end !      
foll[+ new section3  #gccj;,e4          
,precision oncology program = canc] ( ! 
pro/ate  7a7 ,e/abli%m5t ,! ,secret>y   
%all e/abli% )9 ! ,dep>tm5t a precision 
oncology program = canc] ( ! pro/ate 9  
accordance ) ?is section 79 ?is section 

ref]r$ to z ! ,program74  7b7           
,eligibility ,a vet]an is eligible to   
p>ticipate 9 ! ,program if ! vet]an has 
a diagnosis ( pro/ate canc]4  7c7 ,c5t]s
 ( excell5ce  7#a7 ,designation ( c5t]s 
,effective on ! date ( ! enactm5t ( ?is 
section1 ! ,secret>y %all designate !   
foll[+ m$ical facilities ( ! ,dep>tm5t z
 provisional c5t]s ( excell5ce = !      
,program3 7,a7 ,! ,seattle ,,va ,m$ical 
,c5t]1 ,seattle1 ,wa%+ton4  7,b7 ,!     
,james ,j4 ,pet]s ,,va ,m$ical ,c5t]1   
,bronx1 ,new ,york4  7,c7 ,! ,lieut5ant 
,colonel ,*>les ,s4 ,kettles ,,va       
,m$ical ,c5t]1 ,ann ,arbor1 ,mi*igan4   
7,d7 ,! ,m>g>et ,co*ran ,corb9          
,manhattan ,,va ,m$ical ,c5t]1          
,manhattan1 ,new ,york4  7,e7 ,! ,jesse 
,br[n ,dep>tm5t ( ,vet]ans ,affairs     
,m$ical ,c5t]1 ,*icago1 ,ill9ois4  7,f7 
,! ,we/ ,los ,angeles ,,va ,m$ical      
,c5t]1 ,los ,angeles1 ,cali=nia4  7,g7  
,! ,corporal ,mi*ael ,j4 ,cresc5z ,,va  
,m$ical ,c5t]1 ,philadelphia1           
,p5nsylvania4  7,h7 ,! ,durham ,,va     

,m$ical ,c5t]1 ,durham1 ,nor? ,c>ol9a4  
7,i7 ,! ,wa%+ton ,,dc ,,va ,m$ical      
,c5t]1 ,wa%+ton1 ,di/rict ( ,columbia4  
7,j7 ,! ,james ,a4 ,haley ,vet]ans      
,hospital1 ,tampa1 ,florida4  7,k7 ,!   
,portl& ,,va ,m$ical ,c5t]1 ,portl&1    
,oregon4  7,l7 ,! ,jamaica ,pla9 ,,va   
,m$ical ,c5t]1 ,bo/on1 ,massa*usetts4   
7,m7 ,! ,san ,francisco ,,va ,m$ical    
,c5t]1 ,san ,francisco1 ,cali=nia4  7,n7
 ,! ,mi*ael ,e4 ,de,bakey ,dep>tm5t (   
,vet]ans ,affairs ,m$ical ,c5t]1 ,h\/on1
 ,texas4  7,o7 ,! ,rocky ,m\nta9        
,regional ,,va ,m$ical ,c5t]1 ,aurora1  
,colorado4  7,p7 ,! ,john ,j4 ,co*ran   
,vet]ans ,hospital1 ,/4 ,l\is1 ,miss\ri4
  7,q7 ,! ,kansas ,city ,,va ,m$ical    
,c5t]1 ,kansas ,city1 ,miss\ri4  7,r7 ,!
 ,joseph ,maxwell ,clel& ,atlanta ,,va  
,m$ical ,c5t]1 ,decatur1 ,georgia4  7,s7
 ,! ,ralph ,h4 ,johnson ,,va ,m$ical    
,c5t]1 ,*>le/on1 ,s\? ,c>ol9a4  7,t7 ,! 
,orl&o ,,va ,m$ical ,c5t]1 ,orl&o1      
,florida4  7,u7 ,! ,baltimore ,,va      
,m$ical ,c5t]1 ,baltimore1 ,m>yl&4  7,v7

 ,! ,john ,l4 ,mc,clellan ,memorial     
,vet]ans' ,hospital1 ,little ,rock1     
,arkansas4  7,w7 ,! ,william ,s4        
,middleton ,memorial ,vet]ans ,hospital1
 ,madison1 ,wiscons94  7,x7 ,!          
,m9neapolis ,,va ,m$ical ,c5t]1         
,m9neapolis1 ,m9nesota4  7,y7 ,! ,george
 ,e4 ,wahl5 ,dep>tm5t ( ,vet]ans        
,affairs ,m$ical ,c5t]1 ,salt ,lake     
,city1 ,utah4  7,z7 ,! ,c>l ,t4 ,hayd5  
,vet]ans' ,adm9i/ration ,m$ical ,c5t]1  
,pho5ix1 ,arizona4  7,,aa7 ,! ,dallas   
,,va ,m$ical ,c5t]1 ,dallas1 ,texas4    
7,,bb7 ,! ,malcom ,r&all ,dep>tm5t (    
,vet]ans ,affairs ,m$ical ,c5t]1        
,ga9esville1 ,florida4  7#b7 ,op]ational
 requirem5ts  7,a7 ,m9imum numb] ( c5t]s
 ,! ,secret>y %all ensure t1 at all     
times1 n few] ?an #ba m$ical facilities 
( ! ,dep>tm5t are designat$ & op]at+ z  
c5t]s ( excell5ce "u ! ,program1 ) n    
few] ?an "o c5t] ma9ta9$ 9 ea* ,vet]ans 
,integrat$ ,s]vice ,network4  7,b7      
,duration ( secret>ial designation      
,subject to p>agraph 7#c71 ea* c5t]     

designat$ "u ?is section %all be s      
designat$ = a p]iod ( n less ?an five   
ye>s4  7#c7 ,additional designations    
7,a7 ,9 g5]al ,! ,secret>y may designate
 m$ical facilities z c5t]s ( excell5ce 9
 addition to ^? designat$ "u p>agraph   
7#a74  7,b7 ,protection ( initial c5t]s 
,= purposes ( comply+ ) ! m9imum numb] (
 designat$ c5t]s ( excell5ce requirem5t 
"u p>agraph 7#b71 ! ,secret>y %all c\nt 
t[>d su* m9imum numb] any m$ical        
facilities designat$ pursuant to        
p>agraph 7#a7 & n t]m9at$ "u p>agraph   
7#d74  7#d7 ,t]m9ation ( designation    
7,a7 ,9 g5]al ,beg9n+ n e>li] ?an       
,janu>y #a1 #bjcj1 ! ,secret>y may      
t]m9ate ! designation ( a m$ical        
facility z a c5t] ( excell5ce "u !      
,program if ! ,secret>y det]m9es !      
facility is fail+ to s]ve ! purposes ( !
 ,program requir$ by ?is section4  7,b7 
,process ,! ,secret>y-- 7i7 be=e t]m9at+
 a designation "u subp>agraph 7,a71 %all
 submit to ! ,committee on ,vet]ans'    
,affairs & ! ,committee on              

,appropriations ( ! ,s5ate & !          
,committee on ,vet]ans' ,affairs & !    
,committee on ,appropriations ( ! ,h\se 
( ,repres5tatives a notice ( ! int5t to 
t]m9ate ! designation2 &  7ii7 may n    
t]m9ate ! designation until ! date t is 
#fj days aft] ! date ( ! submission (   
su* notice4  7#e7 ,p]=mance reviews     
7,a7 ,9 g5]al ,beg9n+ 9 #bjcj1 !        
,secret>y %all conduct reviews ( !      
p]=mance ( ! c5t]s ( excell5ce designat$
 "u ! ,program4  7,b7 ,roll+ cycle ,9   
c>ry+ out subp>agraph 7,a71 ! ,secret>y 
%all ensure t-- 7i7 9 #bjcj & ea* ye>   
!reaft]1 ! ,secret>y reviews & makes a  
det]m9ation on n m ?an sev5 c5t]s2  7ii7
 ! c5t]s select$ = review 9 any giv5 ye>
 con/itute a class ( c5t]s di/9ct f !   
classes review$ 9 ! prec$+ f\r ye>s2 &  
7iii7 n lat] ?an ! date ( ! submission (
 ! fif? annual report "u subsection 7f7 
foll[+ ! initial conduct ( reviews "u   
?is p>agraph1 & n lat] ?an e fif? ye>   
!reaft]1 e c5t] op]at+ "u ! ,program has
 be5 review$4  7,c7 ,scope ( review ,ea*

 review ( a c5t] "u ?is p>agraph %all   
assess :e!r ! p]=mance ( ! c5t] 9       
provid+ ! s]vices requir$ "u ?is section
 is adequate to ju/ify ! cont9u$        
designation ( ! c5t] z a c5t] (         
excell5ce "u ! ,program4  7d7           
,activities & /aff+ ( c5t]s  7#a7       
,activities ,ea* c5t] designat$ "u      
subsection 7c7 %all c>ry out ! foll[+   
activities3 7,a7 ,e/abli%+ a program (  
g5etic sequ5c+ = vet]ans ) advanc$      
pro/ate canc]4  7,b7 ,in/itut+ a uni=m  
g5etic sequ5c+ plat=m to all[ =         
coord9ation across all c5t]s4  7,c7     
,p>ticipat+ 9 ! telem$ic9e tumor bo>d ( 
! ,program4  7,d7 ,p>ticipat+ 9 !       
regi/ry /udy ( ! ,program to track      
mutations4  7,e7 ,provid+ travel support
 to vet]ans ) mutations to facilitate   
access to /udies4  7,f7 ,develop+       
cl9ical trials t are biom>k] specific4  
7,g7 ,p>ticipat+ 9 indu/ry-sponsor$     
precision oncology /udies4  7,h7        
,p>ticipat+ 9 mon?ly calls & n less ?an 
?ree 9-p]son meet+s p] ye> ) ! ,program 

,lead]%ip team e/abli%$ "u subsection   
7e7 to assess progress4  7,i7 ,provid+  
ongo+ report+ to ! ,program ,lead]%ip   
team reg>d+ trial accruals & rese>*     
conduct$ by inve/igators ( ! ,dep>tm5t )
 limit$ exp]i5ce :o are und]go+         
m5tor%ip4  7,j7 ,e/abli%+ meta/asis     
biopsy capability4  7,k7 ,ext5d+        
res\rces to affiliat$ c5t]s 9 ! ,vet]ans
 ,integrat$ ,s]vice ,network 9 :i* !    
c5t] is locat$4  7#b7 ,/aff+ ,!         
,secret>y %all ensure t ea* c5t]        
designat$ "u subsection 7c7 employs1 at 
a m9imum-- 7,a7 a m$ical oncologi/2     
7,b7 an int]v5tional radiologi/2  7,c7 a
 urologi/2  7,d7 a radiation oncologi/2 
7,e7 a pa?ologi/2 &  7,f7 two full-"t   
equival5t rese>* /aff memb]s4  7e7      
,program lead]%ip  7#a7 ,9 g5]al ,!     
,secret>y %all e/abli% a ,program       
,lead]%ip team locat$ at ! m$ical       
facility designat$ "u subsection        
7c77#a77;,a7 79 ?is section ref]r$ to z 
! ,program ,lead]%ip team74  7#b7       
,composition ,! ,program ,lead]%ip team 

%all include1 at a m9imum1 an ,executive
 ,director1 a ,cl9ical ,director1 & a   
,rese>* ,director4  7#c7 ,duties ,!     
,program ,lead]%ip team %all be         
responsible =-- 7,a7 provid+ /rategic   
liaison s]vices ) indu/ry to ensure     
engagem5t by ! ,dep>tm5t ) /udy design &
 p>ticipation2  7,b7 coord9at+          
p>ticipation by ! ,dep>tm5t 9 pro/ate   
canc] gr\p /udies sponsor$ by !         
,national ,canc] ,in/itute2  7,c7       
facilitat+ ! developm5t ( /udy concepts1
 design1 & />t-up ) inve/igators ( !    
,dep>tm5t ) limit$ exp]i5ce :o are      
und]go+ m5tor%ip2  7,d7 creat+ & execut+
 a model = hybrid dec5traliz$ cl9ical   
trials1 includ+ remote rese>*           
coord9ation1 regulatory />t-up &        
ma9t5ance1 data managem5t1 & approval by
 an in/itutional review bo>d2  7,e7     
creat+ & ma9ta9+ a pro/ate canc] regi/ry
 & data repository ( ! ,dep>tm5t2 &     
7,f7 ma9ta9+ relevant work+ gr\ps to br+
 toge!r exp]tise ( ! ,dep>tm5t f across 
! c\ntry4  7#d7 ,specific               

responsibilities  7,a7 ,executive       
director ,! ,executive ,director ( !    
,program ,lead]%ip team %all-- 7i7      
provide adm9i/rative lead]%ip to !      
,program network 9 p>tn]%ip ) ! ,cl9ical
 ,director2  7ii7 ma9ta9 responsibility 
= ! developm5t1 execution1 & monitor+ ( 
! national /rategic plan ( ! ,program2 &
  7iii7 s]ve z ! liaison to ! executive 
/e]+ committee & o!r lead]%ip ( !       
,dep>tm5t & c5t]s ( excell5ce4  7,b7    
,cl9ical director ,! ,cl9ical ,director 
( ! ,program ,lead]%ip team %all-- 7i7  
ov]see ! ,program network to ensure     
eligible vet]ans receive access to c>e  
bas$ on ! late/ rese>*2  7ii7 ma9ta9    
responsibility = ! developm5t &         
implem5tation ( /rategies = program     
gr[?1 quality improvem5t1 & pati5t      
satisfaction2  7iii7 s]ve on ! review   
committee ( ! ,program = cl9ical trials 
to ensure /udies are conduct$ e?ically &
 effici5tly2 &  7iv7 s]ve z ! liaison ) 
/akehold]s to integrate cl9ical s]vices 
& rese>*4  7,c7 ,rese>* director ,!     

,rese>* ,director ( ! ,program ,lead]%ip
 team %all-- 7i7 provide lead]%ip on    
national rese>* objectives2  7ii7 s]ve  
on committees to review new rese>*      
concepts & projects 9 ! ,program        
network2  7iii7 ma9ta9 a deep und]/&+ ( 
curr5t rese>* & em]g+ te*nologies 9     
pro/ate canc]2 &  7iv7 int]act )        
/akehold]s1 includ+ regulatory ag5cies1 
indu/ry p>tn]s1 & rese>* in/itutions1 to
 improve pro/ate canc] rese>* )9 !      
,dep>tm5t4  7f7 ,annual report  7#a7 ,9 
g5]al ,n lat] ?an ,m>* #a ( ea* ye>1 !  
,secret>y %all submit to ! ,committee on
 ,vet]ans' ,affairs & ! ,committee on   
,appropriations ( ! ,s5ate & !          
,committee on ,vet]ans' ,affairs & !    
,committee on ,appropriations ( ! ,h\se 
( ,repres5tatives a report on !         
,program4  7#b7 ,elem5ts ,ea* report    
submitt$ "u p>agraph 7#a7 %all include1 
) respect to ! p]iod cov]$ by ! report1 
! foll[+3 7,a7 ,! fund+ levels = ea*    
c5t] ( excell5t designat$ "u ! ,program2
  7,b7 ,! numb] ( vet]ans s]v$ by !     

,program2  7,c7 ,! numb] ( inve/igators 
& provid]s p>ticipat+ 9 ! ,program      
network2  7,d7 ,! numb] ( publications  
by provid]s ( ! ,dep>tm5t relat+ to     
pro/ate canc]2  7,e7 ,! numb] ( cl9ical 
rese>* /udies support$ by ! network2    
7,f7 ,! numb] ( vet]ans enroll$ 9 su*   
cl9ical rese>* /udies2  7,g7 ,! five-ye>
 survival rate ( vet]ans enroll$ 9      
cl9ical rese>* /udies ( ! ,program      
comp>$ to o!r vet]ans & civilians )     
pro/ate canc]2 &  7,h7 ,! outcomes &    
survival data = vet]ans s]v$ at d$icat$ 
g5it\r9>y c5t]s "u ! ,program comp>$ to 
t ( o!r vet]ans & civilians s]v$ at o!r 
c5t]s ( excell5ce "u ! ,program4  7#c7  
,compreh5sive plan ,! ,secret>y %all    
include 9 ! report submitt$ "u p>agraph 
7#a7 9 #bjbi1 a compreh5sive plan = !   
designation & op]ation ( ! c5t]s (      
excell5ce "u subsection 7c77#b77;,a71   
includ+ a timel9e = c5t] evaluations1   
p]=mance crit]ia to be utiliz$ 9        
evaluations1 & c5t] selection process4  
7#d7 ,p]=mance review f9d+s ,beg9n+ ) ! 

report submitt$ "u p>agraph 7#a7 9      
#bjca1 & all subsequ5t su* reports1 !   
,secret>y %all include results ( !      
p]=mance reviews conduct$ pursuant to   
subsection 7c77#e71 includ+ a           
det]m9ation by ! ,secret>y reg>d+ :e!r !
 results ( su* review = ea* c5t]        
ju/ifies cont9u$ designation z a c5t] ( 
excell5ce4  7#e7 ,=eca/ ,ea* report     
submitt$ "u p>agraph 7#a7 %all include  
=eca/s ( ! matt] describ$ 9 p>agraph    
7#a77;,a7 = ! upcom+ review p]iod4  4   
7#b7 ,cl]ical am5dm5t ,! table (        
sections at ! beg9n+ ( su* *apt] is     
am5d$ by ins]t+ aft] ! item relat+ to   
section #gccj;,d ! foll[+ new item3     
#gccj;,e4 ,precision oncology program = 
canc] ( ! pro/ate4  4  7b7 ,e/abli%m5t1 
designation1 & op]ation  7#a7 ,9 g5]al  
,! ,secret>y ( ,vet]ans ,affairs %all   
e/abli% ! program requir$ "u section    
#gccj;,e ( title #ch1 ,unit$ ,/ates     
,code1 z add$ by subsection 7a77#a71    
includ+ ! designation ( program lead]%ip
 "u subsection 7e7 ( su* section & !    

designation & op]ation ( ! c5t]s (      
excell5ce "u subsection 7c7 ( su*       
section1 by n lat] ?an ,janu>y #a1      
#bjbg4  7#b7 ,t]ms & conditions ,!      
designation & op]ation ( ! c5t]s (      
excell5ce describ$ 9 p>agraph 7#a7 %all 
be conduct$ "u ! same t]ms & conditions 
& 9 ! same mann] z ^? c5t]s 7 designat$ 
& op]at$ on ,janu>y #a1 #bjbc4  7c7     
,implem5tation plan  7#a7 ,9 g5]al ,n   
lat] ?an #ahj days aft] ! date ( !      
enactm5t ( ?is ,act1 ! ,secret>y (      
,vet]ans ,affairs %all submit to !      
,committee on ,vet]ans' ,affairs & !    
,committee on ,appropriations ( ! ,s5ate
 & ! ,committee on ,vet]ans' ,affairs & 
! ,committee on ,appropriations ( !     
,h\se ( ,repres5tatives a plan = !      
implem5tation ( section #gccj;,e ( title
 #ch1 ,unit$ ,/ates ,code1 z add$ by    
subsection 7a77#a74  7#b7 ,elem5ts ,!   
plan requir$ by p>agraph 7#a7 %all      
include-- 7,a7 an assessm5t ( /aff+     
requir$ at ea* c5t] ( excell5ce         
designat$ "u section #gccj;,e7c7 ( title

 #ch1 ,unit$ ,/ates ,code1 z add$ by    
subsection 7a77#a72  7,b7 an            
id5tification ( contract+ requirem5ts2  
7,c7 a plan = sequ5c+ plat=m selection2 
7,d7 a plan = regi/ry creation2  7,e7 a 
plan = coord9ation ) a c5tral           
in/itutional review bo>d2 &  7,f7 an    
id5tification ( anticipat$ fund+ levels 
= ! #aj-ye> p]iod beg9n+ on ! date ( !  
submittal ( ! plan4  7d7 ,au?orization (
 appropriations ,!re is au?oriz$ to be  
appropriat$ to ! ,secret>y ( ,vet]ans   
,affairs to c>ry out section #gccj;,e ( 
title #ch1 ,unit$ ,/ates ,code1 z add$  
by subsection 7a77#a71 #ae1ejj1jjj = ea*
 ( fiscal ye>s #bjbg ?r\gh #bjbi4