Cancer Survivorship Research and Quality of Life Act of 2006 - Amends the Public Health Service Act to require the Director of the National Cancer Institute (NCI)) to establish and support demonstration, education, and other programs for cancer survivorship.
Requires the Director of the National Institutes of Health (NIH) to: (1) expand and coordinate NIH cancer survivorship research activities; (2) establish a Division of Cancer Survivorship within NCI; and (3) provide for the expansion of cancer survivorship research activities at NCI-designated cancer centers.
Requires the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention (CDC), to: (1) expand the National Comprehensive Cancer Control Program; (2) study the unique health challenges associated with cancer survivorship; and (3) carry out projects and interventions to improve the long-term health status of cancer survivors.
Requires the Secretary to: (1) establish programs that demonstrate how to prevent and control cancer and improve access to quality cancer care among racial and ethnic minorities and medically underserved populations with disproportionate incidence of, or death from, cancer; (2) promote cancer education, prevention, and early detection of cancer; (3) award grants for cancer control and prevention; and (4) establish the National Commission on Cancer Survivorship.
Requires the Secretary, acting through the Directors of CDC and NCI, to make grants to monitor and evaluate the quality of cancer care, develop information concerning the quality of care, and monitor cancer survivorship.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5390 Introduced in House (IH)]
109th CONGRESS
2d Session
H. R. 5390
To provide for the expansion and coordination of activities of the
National Institutes of Health and the Centers for Disease Control and
Prevention with respect to research and programs on cancer
survivorship, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 16, 2006
Mr. Wicker (for himself and Mr. Hoyer) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To provide for the expansion and coordination of activities of the
National Institutes of Health and the Centers for Disease Control and
Prevention with respect to research and programs on cancer
survivorship, and for other purposes.
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 ``Cancer Survivorship Research and
Quality of Life Act of 2006''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) There are more than 10 million cancer survivors (those
living with, through, and beyond cancer) in the United States.
(2) One out of two men and one out of three women will
receive a cancer diagnosis during their lifetime.
(3) One of every four deaths in the United States is from
cancer. In 2005, 570,000 Americans, or more than 1,500 a day,
will die from cancer.
(4) Despite the significant annual burden of cancer deaths,
improvements in detection and treatment have prolonged the
lives of many cancer survivors or resulted in cures for others.
As a result of these developments, the number of survivors
continues to grow.
(5) More than three-fifths of adults diagnosed with cancer
today will be alive five years from now.
(6) In 1960, only four percent of children with cancer
survived more than five years, but treatment advances have
changed the outlook for many children diagnosed with cancer.
(7) The five-year survival rate for children with cancer
improved from 56 percent for those diagnosed between 1974 and
1976 to 79 percent for those diagnosed between 1995 and 2000.
(8) The size of the population of survivors of childhood
cancers has grown dramatically, to 270,000 individuals of all
ages as of 1997, which means that 1 in 640 adults from age 20
to 39 has a history of cancer.
(9) Adults who are treated for cancer may have complex and
long-term effects from their treatment, resulting in unique
health care needs.
(10) Some effects of treatment may be experienced at the
time of treatment or soon after, while others may not be
noticed until the patient ages or develops other health
conditions.
(11) As many as two-thirds of childhood cancer survivors
are likely to experience at least one late effect of treatment,
with as many as one-fourth experiencing a late effect that is
serious or life-threatening.
(12) Some late effects are identified early in follow-up
and are easily resolved, while others may become chronic
problems in adulthood and may have serious consequences.
(13) The late effects of treatment may change as treatments
evolve, which means that the monitoring and treatment of late
effects may need to be modified on a routine basis.
(14) The Institute of Medicine, in its reports on cancer
survivorship entitled ``Childhood Cancer Survivorship:
Improving Care and Quality of Life'' and ``From Cancer Patient
to Cancer Survivor: Lost in Transition,'' has offered a number
of recommendations for improving the monitoring and follow-up
care for cancer survivors and enhancing the cancer survivorship
research agenda.
(15) The Institute of Medicine has also noted the
significant health insurance problems that may be experienced
by survivors of childhood cancer as well as adult cancer
survivors and has recommended that policy makers take action to
ensure access to care, including appropriate follow-up care, by
all cancer survivors.
(16) The annual cost of cancer in the United States is
almost $190 billion in direct and indirect costs.
SEC. 3. CANCER CONTROL PROGRAMS.
Section 412 of the Public Health Service Act (42 U.S.C. 285a-1) is
amended--
(1) in the first sentence, by inserting ``, for
survivorship,'' after ``treatment of cancer'';
(2) in paragraph (1)(B), by striking ``cancer patients''
and all that follows and inserting ``cancer patients, families
of cancer patients, and cancer survivors; and''; and
(3) in paragraph (3), by inserting ``and concerning cancer
survivorship programs,'' after ``control of cancer''.
SEC. 4. EXPANSION AND COORDINATION OF ACTIVITIES OF NATIONAL INSTITUTES
OF HEALTH WITH RESPECT TO CANCER SURVIVORSHIP RESEARCH.
(a) In General.--
(1) Technical amendment.--Section 3 of Public Law 107-172
(116 Stat. 541) is amended by striking ``section 419C'' and
inserting ``section 417C''.
(2) New section.--Subpart 1 of part C of title IV of the
Public Health Service Act (42 U.S.C. 285 et seq.), as amended
pursuant to paragraph (1) of this subsection, is amended by
adding at the end the following section:
``SEC. 417E. CANCER SURVIVORSHIP.
``(a) Expansion and Coordination of Research.--
``(1) In general.--The Director of NIH shall expand and
coordinate the activities of the National Institutes of Health
with respect to cancer survivorship research.
``(2) Priorities.--In carrying out this subsection, the
Director of NIH, in coordination with the Director of the
Centers for Disease Control and Prevention and nonprofit
organizations that focus on cancer survivorship, shall
establish cancer survivorship research priorities.
``(3) Collaboration.--In carrying out this subsection, the
Director of NIH may collaborate with such other agencies as the
Director determines appropriate.
``(b) Division of Cancer Survivorship.--
``(1) Establishment.--In carrying out subsection (a), the
Director of NIH shall establish a Division of Cancer
Survivorship within the National Cancer Institute through which
the research activities under subsection (a) shall be
implemented and directed.
``(2) Director; appointment.--The Director of NIH shall
appoint a Director to head the Division. The Director of the
Division shall be selected from among individuals who, because
of their professional training or experience, are equipped to
address the breadth of needs associated with cancer
survivorship.
``(3) Coordination.--The Director of NIH, acting through
the Director of the Division, shall coordinate and promote the
programs of the National Institutes of Health concerning cancer
survivorship research.
``(4) Definitions.--In this subsection:
``(A) The term `Director of NIH' means the Director
of NIH, acting through the Director of the National
Cancer Institute.
``(B) The term `Division' means the Division of
Cancer Survivorship established under paragraph (1).
``(c) NCI-Designated Cancer Centers.--
``(1) In general.--In carrying out subsection (a), the
Director of NIH shall provide for the expansion and
coordination of cancer survivorship research activities at
National Cancer Institute-designated cancer centers.
``(2) Comprehensive cancer survivorship centers.--
``(A) In general.--The Director of NIH shall
provide assistance to National Cancer Institute-
designated cancer centers for the purpose of
establishing or improving comprehensive cancer
survivorship centers described in subparagraph (B).
``(B) Center description.--A comprehensive cancer
survivorship center described in this subparagraph is a
center within a National Cancer Institute-designated
cancer center designed to serve as a comprehensive,
one-stop source of information, care, and services for
cancer survivors, family members, and service
providers.
``(3) Evaluation of models of survivorship care.--The
Director of NIH shall provide assistance to one or more
National Cancer Institute-designated cancer centers for
research to evaluate models of survivorship care.
``(4) Definition.--In this subsection, the term `Director
of NIH' means the Director of NIH, acting through the Director
of the National Cancer Institute.''.
(b) Funding.--Section 417B of the Public Health Service Act (42
U.S.C. 285a-8) is amended by adding at the end the following
subsection:
``(e) Cancer Survivorship Research.--Of the amounts appropriated
for the National Cancer Institute for a fiscal year, the Director of
the Institute shall reserve not less than $50,000,000 to the Division
of Cancer Survivorship to carry out section 417E (other than section
417E(c)).
``(f) NCI-Designated Cancer Centers.--For the purpose of carrying
out section 417E(c), there are authorized to be appropriated
$61,000,000 for each of fiscal years 2007 through 2011.''.
SEC. 5. NATIONAL COMPREHENSIVE CANCER CONTROL PROGRAM.
Part B of title III of the Public Health Service Act (42 U.S.C. 243
et seq.) is amended by inserting after section 317S the following:
``SEC. 317T. NATIONAL COMPREHENSIVE CANCER CONTROL PROGRAM.
``(a) Expansion of Program.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall
expand and update the National Comprehensive Cancer Control Program.
``(b) Implementation Grants.--
``(1) Authorization.--In carrying out the National
Comprehensive Cancer Control Program, the Secretary may make
grants to eligible entities to establish and implement plans
for an integrated and coordinated approach to reducing cancer
incidence, morbidity, and mortality through prevention, early
detection, treatment, rehabilitation, palliation, and quality-
of-life interventions.
``(2) Submission of plans.--To seek a grant under this
subsection, an eligible entity shall submit a plan for an
integrated and coordinated approach to reducing cancer
incidence, morbidity, and mortality. Such plan shall--
``(A) identify priorities, strategies, and programs
through which communities and their partners may pool
resources to reduce cancer risk, promote cancer
prevention, improve cancer detection, increase access
to health and social services, address disparities in
specific populations, improve cancer treatment, reduce
the burden of cancer, enhance quality of life for
cancer patients, and address survivorship needs; and
``(B) provide for collection, evaluation, and
submission to the Secretary of data on the delivery and
quality of cancer care, screening and early detection
rates, and the quality of life for survivors and their
families.
``(3) Data analysis.--The Secretary shall analyze the data
submitted under this section to ensure that plans funded under
this subsection have a systematic, nationwide, positive impact
on the delivery and quality of cancer care, including by--
``(A) increasing screening and early detection
rates; and
``(B) improving the quality of life for cancer
survivors and their families.
``(4) Definition.--In this section, the term `eligible
entity' includes a State, a territory, a tribal organization,
and the District of Columbia.
``(c) Additional Activities.--In carrying out the National
Comprehensive Cancer Control Program, in addition to making grants
under subsection (b), the Secretary shall--
``(1) establish programs that demonstrate how to prevent
and control cancer and improve access to and the quality of
cancer care among racial and ethnic minority and medically
underserved populations with disproportionate incidence of or
death from cancer;
``(2) promote cancer education, prevention, and early
detection of cancer; and
``(3) award grants to public and nonprofit organizations
for cancer control and prevention.
``(d) Cancer Survivorship Grants.--In carrying out the National
Comprehensive Cancer Control Program, in addition to the activities
described in subsections (b) and (c) the Secretary may award grants to
community-based programs, nonprofit organizations, and other entities
for the purpose of providing programs and direct services to improve
cancer survivorship and the quality of life of cancer survivors.
``(e) Certain Studies and Programs.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention and
in collaboration with the Director of the Division of Cancer
Survivorship in the National Cancer Institute, shall--
``(A) study the unique health challenges associated
with cancer survivorship; and
``(B) carry out (directly or through the award of
grants or contracts) projects and interventions to
improve the long-term health status of cancer
survivors.
``(2) Certain activities.--Activities under paragraph (1)
may include--
``(A) the expansion, in collaboration with the
Surveillance, Epidemiology, and End Results (SEER)
Program at the National Cancer Institute, the National
Program of Cancer Registries at the Centers for Disease
Control and Prevention, and the Agency for Healthcare
Research and Quality, of current cancer surveillance
systems to track the health status of cancer survivors
and determine whether cancer survivors are at-risk for
other chronic and disabling conditions;
``(B) the assessment of the unique public health
challenges associated with cancer survivorship; and
``(C) the implementation and evaluation of the
national public health cancer survivorship action plan,
in partnership with health organizations focused on
cancer survivorship, to be carried out in coordination
with the State programs funded under subsection (b), in
collaboration with the Associate Director for Cancer
Survivorship, and in consultation with other
appropriate entities, to support and advance cancer
survivorship through--
``(i) surveillance and research;
``(ii) communication, education, and
training;
``(iii) program, policies, and
infrastructure; and
``(iv) access to quality care and services.
``(f) Coordination of Activities.--The Secretary shall assure that
activities of the Centers for Disease Control and Prevention under this
section are coordinated as appropriate with other agencies of the
Public Health Service.
``(g) Report to Congress.--Not later than October 1, 2007, the
Secretary shall submit to the Congress a report describing the results
of activities carried out under this section.
``(h) Authorization of Appropriations.--There are authorized to be
appropriated--
``(1) for purposes of this section (other than subsections
(b) and (d)), such sums as may be necessary for each of the
fiscal years 2007 through 2011;
``(2) for purposes of subsection (b), $50,000,000 for
fiscal year 2007 and a total of $200,000,000 for the period of
fiscal years 2008 through 2011; and
``(3) for purposes of subsection (d), $6,000,000 for fiscal
year 2007, $7,000,000 for fiscal year 2008, $8,000,000 for
fiscal year 2009, $9,000,000 for fiscal year 2010, and
$10,000,000 for fiscal year 2011.''.
SEC. 6. MONITORING AND EVALUATING QUALITY CANCER CARE AND CANCER
SURVIVORSHIP.
(a) In General.--Part M of title III of the Public Health Service
Act (42 U.S.C. 280e et seq.) is amended by inserting after section 399E
the following section:
``SEC. 399E-1. MONITORING AND EVALUATING QUALITY CANCER CARE AND CANCER
SURVIVORSHIP.
``(a) In General.--The Secretary shall make grants to eligible
entities for the purpose of enabling such entities to monitor and
evaluate the quality of cancer care, develop information concerning the
quality of cancer care, and monitor cancer survivorship. The Secretary
shall carry out this section jointly through the Director of the
Centers for Disease Control and Prevention and the Director of the
National Cancer Institute.
``(b) Eligible Entities.--For purposes of this section, an entity
is an eligible entity for a fiscal year if the entity--
``(1) operates a statewide cancer registry with funds from
a grant made under section 399B for such fiscal year;
``(2) is certified by the North American Association of
Central Cancer Registries;
``(3) has personnel scientifically qualified to conduct
population-based epidemiology or analyze health services or
outcomes research; and
``(4) has access to a broad-based clinical research cohort
or an established clinical case base.
``(c) Contracting Authority.--In carrying out the purpose described
in subsection (a), an eligible entity may expend a grant under such
subsection to enter into contracts with academic institutions, cancer
centers, and other entities, when determined appropriate by the
Secretary.
``(d) Application for Grant.--A grant may be made under subsection
(a) only if an application for the grant is submitted to the Secretary
and the application is in such form, is made in such manner, and
contains such agreements, assurances, and information as the Secretary
determines to be necessary to carry out this section.
``(e) Authority of Secretary Regarding Use of Grant.--The Secretary
shall determine the appropriate uses of grants under subsection (a) to
achieve the purpose described in such subsection.
``(f) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $5,000,000
for each of the fiscal years 2007 through 2011.''.
(b) Conforming Amendment Regarding Authorization of
Appropriations.--Section 399F(a) of the Public Health Service Act (42
U.S.C. 280e-4(a)) is amended in the first sentence by striking ``this
part,'' and inserting ``this part (other than section 399E-1),''.
SEC. 7. NATIONAL COMMISSION ON CANCER SURVIVORSHIP.
(a) In General.--The Secretary of Health and Human Services shall
establish a National Commission on Cancer Survivorship (referred to in
this section as the ``Commission'') to coordinate the activities of the
Department of Health and Human Services related to cancer survivorship
with such activities of other governmental agencies and private
entities.
(b) Composition.--The Commission shall consist of not more than 15
members to be appointed by the Secretary, of which--
(1) \2/3\ of such members shall be representatives of
governmental agencies conducting activities with respect to
cancer survivorship, including the National Institutes of
Health, the National Cancer Institute, the Centers for Disease
Control and Prevention, the Centers for Medicare & Medicaid
Services, the Health Resources and Services Administration, the
Agency for the Healthcare Research and Quality, the Department
of Defense, and the Department of Veterans Affairs; and
(2) \1/3\ of such members shall be representatives of
private organizations and patient representatives.
(c) Terms.--
(1) In general.--Except as provided in paragraphs (2) and
(3), members of the Commission shall be appointed for a term of
3 years, and may serve an unlimited number of terms if
reappointed.
(2) Terms of initial appointees.--As designated by the
Secretary at the time of appointment, of the 15 members first
appointed--
(A) 5 shall be appointed for a term of 3 years;
(B) 5 shall be appointed for a term of 4 years; and
(C) 5 shall be appointed for a term of 5 years.
(3) Vacancies.--Any member of the Commission appointed to
fill a vacancy occurring before the expiration of the term for
which the member's predecessor was appointed shall be appointed
only for the remainder of that term. A member may serve after
the expiration of that member's term until a successor has
taken office.
(d) Chair.--The Chair of the Commission shall be appointed by the
Secretary of Health and Human Services from among the 15 members of the
Commission. The Chair of the Commission shall be directly responsible
to the Secretary. The Chair of the Commission shall be appointed for a
term of 2 years and may be reappointed.
(e) Annual Report.--The Commission shall prepare an annual report
to Congress on cancer survivorship--
(1) identifying cross-agency activities and public-private
partnerships that support or improve cancer survivorship; and
(2) listing existing and ongoing gaps in care for cancer
survivors.
(f) Administrative Support; Terms of Service; Other Provisions.--
The following shall apply with respect to the Commission:
(1) The Commission shall receive necessary and appropriate
administrative support from the Department of Health and Human
Services.
(2) The Commission shall meet as determined appropriate by
the Secretary, in consultation with the Chair of the
Commission, but not less than 3 times each year.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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