I 

111TH CONGRESS 

2D SESSION H. R. 5560 

To amend the Public Health Service Act to improve quality of cancer care 

and quality of life for patients and survivors by coordinating development 

and distribution of information about relieving pain, symptoms, side 

effects, and stress; increasing awareness of treatment and post-treatment 

health risks for survivors; enhancing research into symptom management 

and survivorship; increasing health care professional education and training; reducing health disparities in cancer treatment, symptom management, and survivorship care; and expanding and enhancing cancer registries; and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 17, 2010 

Mr. MOORE of Kansas (for himself, Ms. BERKLEY, Mr. BERMAN, Mr. CAO, 

Mr. CLAY, Mr. CLEAVER, Mr. CONYERS, Mr. LINCOLN DIAZ-BALART of 

Florida, Ms. EDWARDS of Maryland, Mr. ELLISON, Mr. FRANK of Massachusetts, Ms. KILROY, Mr. LOBIONDO, Mrs. MCCARTHY of New York, 

Mr. MARKEY of Massachusetts, Mr. MEEKS of New York, Ms. MOORE

of Wisconsin, Ms. RICHARDSON, Ms. SCHAKOWSKY, Mr. SPRATT, and Ms. 

WATERS) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to improve quality 

of cancer care and quality of life for patients and survivors by coordinating development and distribution of 

information about relieving pain, symptoms, side effects, 

and stress; increasing awareness of treatment and posttreatment health risks for survivors; enhancing research 

into symptom management and survivorship; increasing 


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health care professional education and training; reducing 

health disparities in cancer treatment, symptom management, and survivorship care; and expanding and enhancing cancer registries; and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Quality Cancer Care 

5 for Life Act of 2010’’. 

6 SEC. 2. IMPROVING QUALITY OF CANCER CARE AND QUAL7 ITY OF LIFE FOR PATIENTS AND SURVIVORS. 

8 Title III of the Public Health Service Act (42 U.S.C. 

9 243 et seq.) is amended by adding at the end the fol10 lowing: 

11 ‘‘SEC. 317U. INFORMATION, SUPPORT, AND OUTCOMES 

12 MONITORING TO IMPROVE QUALITY CARE 

13 AND QUALITY OF LIFE FOR CANCER PA14 TIENTS AND SURVIVORS. 

15 ‘‘(a) IN GENERAL.—The Secretary, acting through 

16 the Director of the Centers for Disease Control and Pre17 vention (in this section referred to as the ‘Director’), shall 

18 improve the quality of cancer care and quality of life for 

19 cancer patients and survivors by expanding cancer control 

20 programs of the Centers for Disease Control and Preven21 tion, including the National Comprehensive Cancer ConVerDate Mar 15 2010 04:19 Jun 18, 2010 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5560.IH H5560

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1 trol Program and the National Program of Cancer Reg2 istries. 

3 ‘‘(b) COORDINATION OF FEDERAL CANCER CARE

4 AND SURVIVORSHIP.— 

5 ‘‘(1) IN GENERAL.—The Secretary shall direct 

6 the coordination of appropriate agencies described in 

7 paragraph (2) for the following purposes: 

8 ‘‘(A) To develop information and support 

9 to States to— 

10 ‘‘(i) incorporate evidence-based, best 

11 practice strategies into Comprehensive 

12 Cancer Control Program activities and 

13 services of such States; and 

14 ‘‘(ii) improve systems of care and care 

15 delivery by including promotion of care 

16 supporting quality of life for cancer pa17 tients, survivors, and the family caregivers 

18 of such patients and survivors. 

19 ‘‘(B) To develop service delivery efforts 

20 with special emphasis on addressing the par21 ticular needs of childhood and adolescent cancer 

22 patients and survivors, as well as patients and 

23 survivors in low-income, racial, or ethnic minor24 ity groups, and other medically underserved 

25 populations. 


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1 ‘‘(C) To improve the National Program of 

2 Cancer Registries and other existing surveil3 lance systems for tracking cancer patients and 

4 survivors and assessing their health status and 

5 risk for other chronic and disabling conditions. 

6 ‘‘(2) APPROPRIATE AGENCIES.—Appropriate 

7 agencies described in this paragraph include the Of8 fice of Cancer Survivorship at the National Cancer 

9 Institute, the National Institute of Nursing Re10 search, and such other appropriate agencies as de11 termined by the Secretary. 

12 ‘‘(c) IMPROVING STATE AND LOCAL PROGRAMS TO

13 ADDRESS CANCER CARE AND SURVIVORSHIP.—In con14 ducting or supporting State and local comprehensive can15 cer control programs through the Centers for Disease 

16 Control and Prevention, the Secretary shall provide fund17 ing and support to States, localities, and territories to ex18 pand and enhance such programs for the following pur19 poses: 

20 ‘‘(1) To include emphasis on quality cancer care 

21 and survivorship, and provide information and sup22 port for quality care initiatives for all cancer patient 

23 and survivor populations including women, children, 

24 adolescent, minority, and other medically under25 served populations. 


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1 ‘‘(2) To develop and strengthen community out2 reach and education programs, resources, interven3 tions, and campaigns; strengthen community infor4 mation delivery systems to inform patients, sur5 vivors, and family members about quality of life sup6 port and services available to relieve pain, symptoms 

7 and stress; increase awareness of treatment and 

8 post-treatment health risks and challenges; and pro9 vide follow-up care important for survivors. Such 

10 programs may— 

11 ‘‘(A) create and disseminate easily acces12 sible, culturally appropriate communication ma13 terials and resources tailored to specific audi14 ences; 

15 ‘‘(B) inform patients, survivors, and family 

16 caregivers about particular symptoms, side ef17 fects, and late effects often associated with spe18 cific types of cancer or treatments and the im19 portance of addressing them as essential ele20 ments of quality health care across the life 

21 course, including information on pain, nausea, 

22 fatigue, or other physical symptoms; worry, 

23 stress, or other psychological or emotional 

24 symptoms; lymphedema; cancer-related oral 

25 health issues and oral care; sexual dysfunction; 


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1 fertility concerns and fertility preservation op2 tions; specific side effects or late effects that 

3 may affect overall health and well being; survi4 vorship follow up care; and any other health-re5 lated conditions that are known to be experi6 enced as a result of cancer by patients, sur7 vivors, and their family caregivers across the 

8 life course; 

9 ‘‘(C) provide resource and referral infor10 mation about other specific issues faced by can11 cer patients, survivors, and their families, in12 cluding financial concerns, employment rights, 

13 medical leave, insurance coverage, anticipating 

14 and managing late effects of treatment and re15 current disease, advance care planning (includ16 ing advance directives, living wills, and durable 

17 powers of attorney), and other care planning in18 volved in health and medical decision-making; 

19 and 

20 ‘‘(D) assist patients, survivors, and family 

21 caregivers with information about how to com22 municate effectively with health professionals 

23 about physical and psychological symptoms, and 

24 limitations or barriers to normal daily function 

25 that may be caused by treatment of cancer. 


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1 ‘‘(3) To include special emphasis on addressing 

2 the particular needs of children and adolescent can3 cer patients and survivors, as well as patients and 

4 survivors in low-income, racial, or ethnic minority 

5 groups, and other medically underserved popu6 lations. 

7 ‘‘(d) CANCER CARE AND SURVIVORSHIP DEM8 ONSTRATION GRANTS.— 

9 ‘‘(1) IN GENERAL.—The Director shall award 

10 competitive grants to States, localities, and not-for11 profit organizations for the purposes of developing, 

12 implementing, and evaluating cancer case manage13 ment and coordination programs to enhance the 

14 quality of cancer care and quality of life for patients 

15 and survivors and to improve cancer outcomes. Spe16 cific emphasis shall be on addressing relief of symp17 toms, pain, side effects, and stress; increasing pa18 tient awareness of treatment and post-treatment 

19 health risks; and survivor care. 

20 ‘‘(2) APPLICATION.—A State, locality, or not21 for-profit organization seeking a grant under this 

22 subsection shall submit to the Director an applica23 tion (at such time, in such manner, and containing 

24 such information as the Director may require), inVerDate Mar 15 2010 04:19 Jun 18, 2010 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5560.IH H5560

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1 cluding assurances that the State, locality, or entity 

2 will— 

3 ‘‘(A) serve medically underserved popu4 lations through specific outreach activities and 

5 coordinate culturally competent and appropriate 

6 care in accordance with existing, relevant de7 partmental guidelines; and 

8 ‘‘(B) evaluate and disseminate to the pub9 lic annually detailed information about program 

10 activities. 

11 ‘‘(3) USE OF FUNDS.—A State, locality, or not12 for-profit entity shall use grant amounts awarded 

13 under this subsection to carry out programs that 

14 create partnerships with community organizations, 

15 including health care providers, cancer centers, hos16 pitals, community health centers, palliative care pro17 grams, psychosocial care programs, hospice pro18 grams, home care, nonprofit organizations, health 

19 plans to facilitate access to integrated care services 

20 that support quality of life needs for patients, sur21 vivors, and family caregivers. Such activities shall in22 clude— 

23 ‘‘(A) patient navigation and referrals, in24 cluding assistance to patients and survivors in 

25 finding support groups; 


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1 ‘‘(B) interventions for patients, survivors, 

2 and caregivers; pain management; palliative 

3 care; psychosocial care; hospice; or other end of 

4 life care programs; 

5 ‘‘(C) general advocacy on behalf of pa6 tients, survivors, and families; and 

7 ‘‘(D) an evaluation to identify best prac8 tices to improve the coordination of cancer and 

9 survivorship care services and activities. 

10 ‘‘(4) EVALUATION AND REPORTING.—The Di11 rector shall evaluate activities funded under this 

12 subsection and shall submit to Congress (and dis13 seminate to the public) reports related to such eval14 uation, including findings, outcomes, and other pro15 gram information. The first report shall be sub16 mitted not later than January 1, 2013, with updates 

17 provided every three years thereafter. 

18 ‘‘(e) HEALTH CARE PROFESSIONAL EDUCATION AND

19 TRAINING DEMONSTRATION GRANTS.— 

20 ‘‘(1) IN GENERAL.—The Director shall award 

21 competitive grants to not-for-profit entities or quali22 fied individuals for the purpose of training individ23 uals to undertake the quality of life needs of cancer 

24 patients, survivors, and family caregivers. 


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1 ‘‘(2) APPLICATION.—A not-for-profit entity or 

2 qualified individual seeking a grant under this sub3 section shall submit an application to the Director at 

4 such time, and in such manner, and containing such 

5 information as the Director may require, including 

6 assurances that the entity or individual will— 

7 ‘‘(A) improve health professional commu8 nication skills in caring for patients and sur9 vivors to more effectively assess and address 

10 their quality of life or survivorship concerns; 

11 ‘‘(B) assess and relieve pain, symptoms, 

12 side effects, and stress associated with cancer 

13 and its treatment; 

14 ‘‘(C) promote care planning to align treat15 ment with patient and family goals; 

16 ‘‘(D) anticipate and communicate about 

17 cancer treatment and post-treatment health 

18 risks and follow-up care; 

19 ‘‘(E) provide palliative, psychosocial, or 

20 other care to support quality of life integrated 

21 as part of disease-directed treatment to improve 

22 quality of cancer care; 

23 ‘‘(F) promote use of survivorship care 

24 planning; 


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1 ‘‘(G) improve cultural sensitivity, commu2 nication, and patient care for minority and 

3 medically underserved populations, including 

4 addressing the particular needs of children, 

5 adolescents, and their families; racial and ethnic 

6 groups, and other medically underserved cancer 

7 patient and survivor populations; and 

8 ‘‘(H) collect and analyze data related to 

9 the effectiveness of education and training ef10 forts. 

11 ‘‘(3) USE OF FUNDS.—An eligible entity shall 

12 use grant amounts awarded under this subsection to 

13 train and develop individuals with skills needed to 

14 assist the quality of life needs of cancer patients, 

15 survivors, and family caregivers by addressing symp16 toms, pain, side effects, stress, treatment, and post17 treatment health risks and train individuals to assist 

18 in arranging follow-up care across the life course. 

19 ‘‘(4) EVALUATION.—The Secretary shall de20 velop and implement a plan for evaluating the ef21 fects of professional training programs funded 

22 through this subsection. 

23 ‘‘(5) DEFINITION.—For purposes of this sub24 section, the term ‘qualified individual’ means a phy25 sician, nurse, social worker, chaplain, psychologist, 


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1 or other individual who is involved in providing pal2 liative care and symptom management services to 

3 cancer patients. 

4 ‘‘(f) QUALITY OF LIFE ADVISORY COMMITTEE.— 

5 ‘‘(1) ESTABLISHMENT.—Not later than 90 days 

6 after the date of the enactment of this section, the 

7 Secretary shall establish a Quality of Life Advisory 

8 Committee (in this subsection referred to as the ‘ad9 visory committee’) to advise, coordinate, and assist 

10 the Centers for Disease Control and Prevention in 

11 creating and conducting the cancer quality of life 

12 and survivorship activities, program enhancements, 

13 and training initiatives specified in subsections (a) 

14 through (e). 

15 ‘‘(2) MEMBERSHIP.—The Secretary shall ap16 point to the advisory committee such members as 

17 the Secretary considers necessary, and shall include 

18 individuals and representatives of public and private 

19 organizations with expertise in cancer treatment and 

20 care; pain, symptom, and stress management; and 

21 cancer survivorship. 

22 ‘‘(3) DUTIES.—The advisory committee shall 

23 meet at least once a year and shall— 

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1 ment and survivorship research relevant to the 

2 goals of this section and identify gaps in basic, 

3 clinical, behavioral, or other research required 

4 to achieve further improvements in care to sup5 port quality of life and survivorship; and 

6 ‘‘(B) annually submit to the Secretary a 

7 report on the findings described in subpara8 graph (A) with recommendations about addi9 tional research needed to improve care for can10 cer patients, survivors, and families that will 

11 support quality of life and survivorship. 

12 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—To 

13 carry out this section, there is authorized to be appro14 priated such sums as are necessary.’’. 

15 SEC. 3. ENHANCING RESEARCH IN SUPPORT OF QUALITY 

16 OF LIFE, AND CANCER SURVIVORSHIP. 

17 Part B of title IV of the Public Health Service Act 

18 (42 U.S.C. 284 et seq.) is amended by adding at the end 

19 the following: 

20 ‘‘SEC. 409K. QUALITY CANCER CARE AND CANCER SURVI21 VORSHIP RESEARCH. 

22 ‘‘(a) IN GENERAL.—The Director of the National In23 stitutes of Health shall, in coordination with recommenda24 tions of the Quality of Life Advisory Committee estab25 lished under section 317U(f), undertake additional cancer 


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1 quality of life and survivorship research that addresses 

2 pain, symptom management, side effects and late effects, 

3 and psychosocial factors to improve cancer clinical com4 munication and care planning, treatment and post-treat5 ment, and follow-up care across the life course. 

6 ‘‘(b) AUTHORIZED RESEARCH.—Research supported 

7 under this section may include at least the following: 

8 ‘‘(1) Examination of evidence-based practices 

9 relating to cancer care, survivorship, and follow-up 

10 care including comparing community-based public 

11 health interventions. 

12 ‘‘(2) Analysis of the translation of cancer inter13 ventions from academic settings to real world set14 tings. 

15 ‘‘(3) Lifestyle, behavioral, and other research 

16 on the impact of cancer treatment and survivorship. 

17 ‘‘(4) Formative research to assist with the de18 velopment of educational messages and information, 

19 for dissemination to targeted populations such as 

20 children, adolescents, racial and ethnic minority 

21 groups, and other medically underserved groups, on 

22 the residual effects of cancer treatment. 

23 ‘‘(5) Health disparities in cancer survivorship 

24 outcomes within minority or other medically under25 served populations. 


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1 ‘‘(6) Intervention research to prevent or treat 

2 the post-treatment effects of cancer treatment. 

3 ‘‘(7) Identification of the unique needs of pa4 tients who are diagnosed with rare or deadly cancers 

5 or cancers that have not been well studied. 

6 ‘‘(8) Development of a consistent, standardized 

7 model of service delivery for cancer-related follow-up 

8 care across cancer centers and community oncology 

9 practices. 

10 ‘‘(9) Development, testing, and communication 

11 of messages for patients, survivors, and health pro12 fessionals that will improve understanding, demand 

13 for, and delivery of care to relieve pain, symptoms, 

14 stress, and other quality of life factors associated 

15 with serious illnesses such as cancer. 

16 ‘‘(c) FUNDING.—Such funds as necessary to accom17 plish the requirements of subsection (a) shall be available 

18 from funds reserved under section 402A(c)(1) for the 

19 Common Fund or otherwise available for such initia20 tives.’’. 

Æ 


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