I 118th CONGRESS 1st Session H. R. 6338 IN THE HOUSE OF REPRESENTATIVES November 9, 2023 Ms. Garcia of Texas introduced the following bill; which was referred to the Committee on Veterans' Affairs A BILL To direct the Secretary of Veterans Affairs to establish a pilot program for gynecologic cancer care coordination at the Department of Veterans Affairs, and for other purposes.

1. Short title This Act may be cited as the Veterans’ Cancer Care Coordinator Act of 2023 . 2. Pilot program on gynecologic cancer care coordination (a) Establishment Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish a pilot program (in this section referred to as the Program ) for gynecologic cancer care coordination at the Department of Veterans Affairs, including through the designation of a gynecologic cancer care coordinator of the Department. (b) Eligible participants A veteran is eligible to participate in the program if the veteran— (1) has been diagnosed with a gynecologic cancer; and (2) is eligible for health care furnished through the Veterans Community Care Program under section 1703 of title 38, United States Code, at a non-Department facility. (c) Locations The Secretary shall select not fewer than five medical centers of the Department of Veterans Affairs at which to carry out the Program, including one medical center that primarily serves rural veterans, as determined by the Secretary. (d) Duties of gynecologic cancer care coordinator Under the Program, the designated gynecologic cancer care coordinator shall be responsible for carrying out the following duties: (1) Ensuring the coordination of care between— (A) clinicians of the Department and community gynecologic cancer care providers; (B) clinicians of the Department, Women’s Veteran Program Managers, and Women’s Health Medical Directors; and (C) any other relevant clinicians of the Department and community care providers who provide care to participating veterans. (2) Working with the Office of Community Care of the relevant medical facility of the Department regarding authorizations of care in the community, including for participating veterans whose mental health screening results indicate the presence of military sexual trauma, depression, domestic or intimate partner violence, or post-traumatic stress disorder. (3) Making regular contact with each participating veteran when the veteran receives care from a community care provider to evaluate the needs of the veteran, including through an assessment of the mental health of the veteran (including as such mental health and trauma history related to the cancer diagnosis of the veteran). (4) Monitoring— (A) the services furnished under the Program to participating veterans; (B) the outcomes relating to the health of such participating veterans, including remission, metastasis, and death; and (C) the data relating to gynecologic cancer care collected at a medical facility of the Department (using relevant databases of the Veterans Health Administration or other Department databases), including— (i) the demographics of participating veterans who have gynecologic cancer; and (ii) the number of participating veterans being treated for gynecologic cancer. (5) Providing particular information to participating veterans, including— (A) how to seek emergency care at the emergency department closest to the veteran, including the requirement for the veteran or the community care provider to notify the Department when the veteran receives emergency treatment relating to the cancer of the veteran for the Department to authorize payment for such emergency treatment; and (B) information about mental health resources, including with respect to information encouraging follow-up care for depression. (6) Documenting certain information in the electronic health records of participating veterans, including— (A) the documentation of the contact described in paragraph (3); (B) the contact information of the community gynecologic cancer care providers of such participating veterans; and (C) the cancer diagnosis of such participating veterans. (7) Carrying out such other duties as may be determined appropriate by the Secretary. (e) Report (1) In general Not later than two years after the date on which the Secretary commences the Program, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report containing the following: (A) A comparison of the outcomes of veterans who have participated in the Program to the outcomes of non-participating veterans described in paragraph (2), including with respect to the following: (i) Health outcomes, including (for the most recent two years of available data)— (I) the percentage of such veterans who have experienced a cancer-related death; (II) the percentage of such veterans who have entered remission for gynecologic cancer; and (III) the percentage of such veterans who have been diagnosed with mental health disorders determined relevant by the Secretary for purposes of the comparison (including anxiety, depression, and post-traumatic stress disorder). (ii) Timeliness of care furnished under chapter 17 of title 38, United States Code, including the average time that elapses between the initial diagnosis and each successive stage of treatment for gynecologic cancer. (iii) Patient safety associated with such care, including the number of errors in medical care that rise to the level of never events (such as a foreign body left in a veteran during surgery). (iv) Patient satisfaction associated with such care, including the results of a patient satisfaction survey administered to such veterans on the receipt of adequate pain management from health care providers of the Department, mental health resources from such providers, and overall quality of such care. (B) An evaluation of whether to expand the Program or make such Program permanent. (C) Any other matter the Secretary determines appropriate. (2) Non-participating veterans described A non-participating veteran described in this paragraph is a female veteran who— (A) has not participated in the Program; (B) is enrolled in the patient enrollment system of the Department of Veterans Affairs established and operated under section 1705 of title 38, United States Code; and (C) has been diagnosed with gynecologic cancer. (f) Definitions In this section: (1) The term community care provider means a health care provider located at a non-Department facility who provides care (other than care related to gynecologic cancer) to veterans under section 1703 of title 38, United States Code, or any other law administered by the Secretary of Veterans Affairs. (2) The term community gynecologic cancer care provider means a gynecologic cancer care provider located at a non-Department facility who provides care related to gynecologic cancer to veterans under section 1703 of title 38, United States Code, or any other law administered by the Secretary of Veterans Affairs. (3) The term gynecologic cancer means cervical cancer, ovarian cancer, uterine cancer, vaginal cancer, and vulvar cancer. (4) The term non-Department facilities has the meaning given that term in section 1701 of title 38, United States Code. (5) The term participating veteran means a veteran who is participating in the Program. (6) The term Women’s Health Medical Director means a Women’s Health Medical Director described in the directive of the Veterans Health Administration titled Health Care Services for Women Veterans (directive 1330.01), or any successor directive. (7) The term Women’s Veteran Program Manager means a Women’s Veterans Program Manager described in the directive of the Veterans Health Administration titled Women Veterans Program Manager (directive 1330.02), or any successor directive.