HB 3528

                                 SECOND REGULAR SESSION
                    HOUSE BILL NO. 3528
                           103RD GENERAL ASSEMBLY
                           INTRODUCED BY REPRESENTATIVE BYRNES.
 7469H.01I  JOSEPH ENGLER, Chief Clerk
                                            AN ACT
 To amend chapter 192, RSMo, by adding thereto one new section relating to the Missouri
       environmental exposure early cancer detection act.
 Be it enacted by the General Assembly of the state of Missouri, as follows:
        Section A. Chapter 192, RSMo, is amended by adding thereto one new section, to be
2 known as section 192.529, to read as follows:
        192.529. 1. This section shall be known and may be cited as the "Missouri
2 Environmental Exposure Early Cancer Detection Act".
32. As used in this section, the following terms mean:
4(1) "At-risk populations", individuals residing, attending school, or working in
5 areas with documented environmental exposure to carcinogens;
6(2) "Department", the department of health and senior services;
7(3) "Liquid biopsy", a noninvasive blood test that detects DNA fragments
8 indicative of multiple types of cancers before symptoms arise;
9(4) "Precision", the deliberate integration of advanced diagnostic methods to
10 improve health outcomes and reduce disparities among populations most at risk of late-
11 stage cancer diagnoses;
12(5) "Screening program", the pilot multicancer detection liquid biopsy screening
13 program described in subsection 3 of this section;
14(6) "Testing entity", a health system that:
15(a) Has a large primary care provider base with extensive experience that
16 practices precision medicine;
 EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
 intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language.
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17(b) Uses a multicancer liquid biopsy test that tests for more than fifty types of
18 cancer and that includes signal of origin;
19(c) Has patient-facing web-based education on the multicancer liquid biopsy test
20 and the implications of participating in the screening program;
21(d) Has an established peer-review process to review positive results on the
22 multicancer liquid biopsy test; and
23(e) Has a process for shared decision-making with patients following the receipt
24 of results on the multicancer liquid biopsy test.
253. (1) The department, in collaboration with a testing entity, shall develop and
26 implement a pilot multicancer detection liquid biopsy screening program that screens
27 participants for cancer using a multicancer liquid biopsy test.
28(2) The screening program shall:
29(a) Prioritize voluntary screening for identified at-risk populations;
30(b) Establish accessible pathways for participation, ensuring geographic and
31 economic equity; and
32(c) Collaborate with health care providers and community organizations for
33 effective outreach, education, and enrollment of eligible individuals.
344. (1) The general assembly shall appropriate funds sufficient to support the
35 implementation, management, and evaluation of a pilot program to assist individuals
36 with prolonged exposure to toxic agents including, but not limited to:
37(a) Individuals residing, attending school, or working in environmentally
38 contaminated areas, such as those near Coldwater Creek and Weldon Spring; and
39(b) First responders, with priority for assistance given to firefighters.
40(2) The department shall pursue available federal grants and public-private
41 partnerships to enhance funding and resource availability.
42(3) Funds appropriated in accordance with this subsection shall specifically
43 support patient outreach, counseling, and testing costs for individuals with prolonged
44 exposure to toxic agents.
455. The department shall submit to the general assembly and make publicly
46 available an annual report on the screening program detailing participation rates,
47 cancer detection rates, stage of diagnosis for participants diagnosed with cancer,
48 demographic analyses, cost-effectiveness, and recommendations for improvement.
496. (1) An advisory council is hereby established within the department to work
50 with the testing entity to define at-risk populations and oversee the implementation and
51 progress of the screening program as well as the compliance of the screening program
52 with the requirements of this section. The advisory council shall be composed of eleven
53 members, appointed by the director of the department, and shall include medical
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54 experts, patient advocates, environmental health specialists, and representatives from
55 impacted communities.
56(2) The advisory council shall regularly review screening program data from the
57 testing entity and provide strategic recommendations to the testing entity to ensure
58 ongoing program improvement and equitable access.
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