National Breast and Cervical Cancer Early Detection Program Reauthorization Act of 2007

        [Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 624 Reported in Senate (RS)]

Calendar No. 100
110th CONGRESS
1st Session
S. 624

To amend the Public Health Service Act to provide waivers relating to
grants for preventive health measures with respect to breast and
cervical cancers.

_______________________________________________________________________

IN THE SENATE OF THE UNITED STATES

February 15, 2007

Ms. Mikulski (for herself, Mrs. Hutchison, Mr. Harkin, Mr. Dodd, Mr.
Kerry, Mr. Menendez, Mr. Schumer, Ms. Collins, Mr. Bayh, Mr. Biden,
Mrs. Clinton, Mrs. Boxer, Ms. Snowe, Ms. Stabenow, Mr. Enzi, Mr. Hatch,
and Mr. Kennedy) introduced the following bill; which was read twice
and referred to the Committee on Health, Education, Labor, and Pensions

March 29, 2007

Reported by Mr. Kennedy, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]

_______________________________________________________________________

A BILL

To amend the Public Health Service Act to provide waivers relating to
grants for preventive health measures with respect to breast and
cervical cancers.

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

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``National Breast and
Cervical Cancer Early Detection Program Reauthorization Act of
2007''.</DELETED>

<DELETED>SEC. 2. NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION
PROGRAM.</DELETED>

<DELETED>    Title XV of the Public Health Service Act (42 U.S.C. 300k
et seq.) is amended--</DELETED>
<DELETED>    (1) in section 1501(d)--</DELETED>
<DELETED>    (A) in the heading, by striking ``2000''
and inserting ``2020''; and</DELETED>
<DELETED>    (B) by striking ``by the year 2000'' and
inserting ``by the year 2020'';</DELETED>
<DELETED>    (2) in section 1503, by adding at the end the
following:</DELETED>
<DELETED>    ``(d) Waiver of Services Requirement on Division of
Funds.--</DELETED>
<DELETED>    ``(1) In general.--The Secretary shall establish a
demonstration project under which the Secretary, acting through
the Director of the Centers for Disease Control and Prevention,
may waive the requirements of paragraphs (1) and (4) of
subsection (a) for not more than 5 States, if--</DELETED>
<DELETED>    ``(A)(i) the State involved will use the
waiver to leverage private funds to supplement each of
the services or activities described in paragraphs (1)
and (2) of section 1501(a); or</DELETED>
<DELETED>    ``(ii) the application of such requirement
would result in a barrier to the enrollment of
qualifying women;</DELETED>
<DELETED>    ``(B) the State involved provides
assurances that the State will, on an annual basis,
demonstrate to the Secretary the manner in which the
State will use such waiver to maintain or expand the
level of screening and follow-up services provided
immediately prior to the waiver, and provide
documentation of compliance with such maintenance or
expansion requirement;</DELETED>
<DELETED>    ``(C) the State involved submits to the
Secretary a plan for maintaining the level of
activities carried out under the waiver after the
expiration of the waiver;</DELETED>
<DELETED>    ``(D) the Secretary finds that granting
such a waiver to a State will not reduce the number of
women in the State that receive each of the services or
activities described in paragraphs (1) and (2) of
section 1501(a), including making available screening
procedures for both breast and cervical cancers;
and</DELETED>
<DELETED>    ``(E) the Secretary finds that granting
such a waiver to a State will not adversely affect the
quality of each of the services or activities described
in paragraphs (1) and (2) of section 1501(a).</DELETED>
<DELETED>    ``(2) Duration of waiver.--</DELETED>
<DELETED>    ``(A) In general.--In granting waivers
under paragraph (1), the Secretary--</DELETED>
<DELETED>    ``(i) shall grant such waivers for
a period of 2 years; and</DELETED>
<DELETED>    ``(ii) upon request of a State,
may extend a waiver for an additional 2-year
period in accordance with subparagraph
(B).</DELETED>
<DELETED>    ``(B) Additional period.--The Secretary,
upon the request of a State that has received a waiver
under paragraph (1), shall, at the end of the 2-year
waiver period described in subparagraph (A), review
performance under the waiver and may extend the waiver
for an additional 2-year period if the Secretary
determines that--</DELETED>
<DELETED>    ``(i)(I) without an extension of
the waiver, there will be a barrier to the
enrollment of qualifying women; or</DELETED>
<DELETED>    ``(II) the State requesting such
extended waiver will use the waiver to leverage
private funds to supplement the services or
activities described in paragraphs (1) and (2)
of section 1501(a);</DELETED>
<DELETED>    ``(ii) the waiver has not, and
will not, reduce the number of women in the
State that receive the services or activities
described in paragraphs (1) and (2) of section
1501(a);</DELETED>
<DELETED>    ``(iii) the waiver has not, and
will not, result in lower quality in the State
of the services or activities described in
paragraphs (1) and (2) of section 1501(a);
and</DELETED>
<DELETED>    ``(iv) the State has maintained
the average annual level of State fiscal
expenditures for the services and activities
described in paragraphs (1) and (2) of section
1501(a) for the 2 years for which the waiver
was granted at a level that is not less than
the level of the State fiscal expenditures for
such services and activities for the year
preceding the first year for which the waiver
is granted.</DELETED>
<DELETED>    ``(3) Reporting requirements.--The Secretary shall
include as part of the evaluations and reports required under
section 1508, the following:</DELETED>
<DELETED>    ``(A) A description of the total amount of
dollars leveraged annually from private entities in
States receiving a waiver under paragraph (1) and how
these amounts were used.</DELETED>
<DELETED>    ``(B) With respect to States receiving a
waiver under paragraph (1), a description of the
percentage of the grant that is expended on providing
each of the services or activities described in--
</DELETED>
<DELETED>    ``(i) paragraphs (1) and (2) of
section 1501(a); and</DELETED>
<DELETED>    ``(ii) paragraphs (3) through (6)
of section 1501(a).</DELETED>
<DELETED>    ``(C) A description of the number of
States receiving waivers under paragraph (1)
annually.</DELETED>
<DELETED>    ``(D) With respect to States receiving a
waiver under paragraph (1), a description of--
</DELETED>
<DELETED>    ``(i) the number of women
receiving services under paragraphs (1), (2),
and (3) of section 1501(a) in programs before
and after the granting of such waiver;
and</DELETED>
<DELETED>    ``(ii) the average annual level of
State fiscal expenditures for the services and
activities described in paragraphs (1) and (2)
of section 1501(a) for the year preceding the
first year for which the waiver was
granted.</DELETED>
<DELETED>    ``(4) Limitation.--Amounts to which a waiver
applies under this subsection shall not be used to increase the
number of salaried employees.</DELETED>
<DELETED>    ``(5) Definitions.--In this subsection:</DELETED>
<DELETED>    ``(A) Indian tribe.--The term `Indian
tribe' has the meaning given the term in section 4 of
the Indian Health Care Improvement Act (25 U.S.C.
1603).</DELETED>
<DELETED>    ``(B) Tribal organization.--The term
`tribal organization' has the meaning given the term in
section 4 of the Indian Health Care Improvement
Act.</DELETED>
<DELETED>    ``(C) State.--The term `State' means each
of the several States of the United States, the
District of Columbia, the Commonwealth of Puerto Rico,
American Samoa, the Commonwealth of the Northern
Mariana Islands, the Republic of the Marshall Islands,
the Federated States of Micronesia, the Republic of
Palau, an Indian tribe, and a tribal
organization.'';</DELETED>
<DELETED>    (3) in section 1508--</DELETED>
<DELETED>    (A) in subsection (a), by striking
``evaluations of the extent to which'' and all that
follows through the period and inserting: ``evaluations
of--</DELETED>
<DELETED>    ``(1) the extent to which States carrying out such
programs are in compliance with section 1501(a)(2) and with
section 1504(c); and</DELETED>
<DELETED>    ``(2) the extent to which each State receiving a
grant under this title is in compliance with section 1502,
including identification of--</DELETED>
<DELETED>    ``(A) the amount of the non-Federal
contributions by the State for the preceding fiscal
year, disaggregated according to the source of the
contributions; and</DELETED>
<DELETED>    ``(B) the proportion of such amount of
non-Federal contributions relative to the amount of
Federal funds provided through the grant to the State
for the preceding fiscal year.''; and</DELETED>
<DELETED>    (B) in subsection (b), by striking ``not
later than 1 year after the date on which amounts are
first appropriated pursuant to section 1509(a), and
annually thereafter'' and inserting ``not later than 1
year after the date of the enactment of the National
Breast and Cervical Cancer Early Detection Program
Reauthorization of 2007, and annually thereafter'';
and</DELETED>
<DELETED>    (4) in section 1510(a)--</DELETED>
<DELETED>    (A) by striking ``and'' after
``$150,000,000 for fiscal year 1994,''; and</DELETED>
<DELETED>    (B) by inserting ``, $225,000,000 for
fiscal year 2008, $245,000,000 for fiscal year 2009,
$250,000,000 for fiscal year 2010, $255,000,000 for
fiscal year 2011, and $275,000,000 for fiscal year
2012'' before the period at the end.</DELETED>

SECTION 1. SHORT TITLE.

This Act may be cited as the ``National Breast and Cervical Cancer
Early Detection Program Reauthorization Act of 2007''.

SEC. 2. NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM.

Title XV of the Public Health Service Act (42 U.S.C. 300k et seq.)
is amended--
(1) in section 1501(d)--
(A) in the heading, by striking ``2000'' and
inserting ``2020''; and
(B) by striking ``by the year 2000'' and inserting
``by the year 2020'';
(2) in section 1503, by adding at the end the following:
``(d) Waiver of Services Requirement on Division of Funds.--
``(1) In general.--The Secretary shall establish a
demonstration project under which the Secretary may waive the
requirements of paragraphs (1) and (4) of subsection (a) for
not more than 5 States, if--
``(A) the State involved will use the waiver to
leverage non-Federal funds to supplement each of the
services or activities described in paragraphs (1) and
(2) of section 1501(a);
``(B) the application of such requirement would
result in a barrier to the enrollment of qualifying
women;
``(C) the State involved--
``(i) demonstrates, to the satisfaction of
the Secretary, the manner in which the State
will use such waiver to expand the level of
screening and follow-up services provided
immediately prior to the date on which the
waiver is granted; and
``(ii) provides assurances, satisfactory to
the Secretary, that the State will, on an
annual basis, demonstrate, through such
documentation as the Secretary may require,
that the State has used such waiver as
described in clause (i);
``(D) the State involved submits to the Secretary--
``(i) assurances, satisfactory to the
Secretary, that the State will maintain the
average annual level of State fiscal year
expenditures for the services and activities
described in paragraphs (1) and (2) of section
1501(a) for the period for which the waiver is
granted, and for the period for which any
extension of such wavier is granted, at a level
that is not less than--
``(I) the level of the State fiscal
year expenditures for such services and
activities for the fiscal year
preceding the first fiscal year for
which the waiver is granted; or
``(II) at the option of the State
and upon approval by the Secretary, the
average level of the State expenditures
for such services and activities for
the 3-fiscal year period preceding the
first fiscal year for which the waiver
is granted; and
``(ii) a plan, satisfactory to the
Secretary, for maintaining the level of
activities carried out under the waiver after
the expiration of the waiver and any extension
of such waiver;
``(E) the Secretary finds that granting such a
waiver to a State will increase the number of women in
the State that receive each of the services or
activities described in paragraphs (1) and (2) of
section 1501(a), including making available screening
procedures for both breast and cervical cancers; and
``(F) the Secretary finds that granting such a
waiver to a State will not adversely affect the quality
of each of the services or activities described in
paragraphs (1) and (2) of section 1501(a).
``(2) Duration of waiver.--
``(A) In general.--In granting waivers under
paragraph (1), the Secretary--
``(i) shall grant such waivers for a period
that is not less than 1 year but not more than
2 years; and
``(ii) upon request of a State, may extend
a waiver for an additional period that is not
less than 1 year but not more than 2 years in
accordance with subparagraph (B).
``(B) Additional period.--The Secretary, upon the
request of a State that has received a waiver under
paragraph (1), shall, at the end of the waiver period
described in subparagraph (A)(i), review performance
under the waiver and may extend the waiver for an
additional period if the Secretary determines that--
``(i) without an extension of the waiver,
there will be a barrier to the enrollment of
qualifying women;
``(ii) the State requesting such extended
waiver will use the waiver to leverage non-
Federal funds to supplement the services or
activities described in paragraphs (1) and (2)
of section 1501(a);
``(iii) the waiver has increased, and will
continue to increase, the number of women in
the State that receive the services or
activities described in paragraphs (1) and (2)
of section 1501(a);
``(iv) the waiver has not, and will not,
result in lower quality in the State of the
services or activities described in paragraphs
(1) and (2) of section 1501(a); and
``(v) the State has maintained the average
annual level of State fiscal expenditures for
the services and activities described in
paragraphs (1) and (2) of section 1501(a) for
the period for which the waiver was granted at
a level that is not less than--
``(I) the level of the State fiscal
year expenditures for such services and
activities for the fiscal year
preceding the first fiscal year for
which the waiver is granted; or
``(II) at the option of the State
and upon approval by the Secretary, the
average level of the State expenditures
for such services and activities for
the 3-fiscal year period preceding the
first fiscal year for which the waiver
is granted.
``(3) Reporting requirements.--The Secretary shall include
as part of the evaluations and reports required under section
1508, the following:
``(A) A description of the total amount of dollars
leveraged annually from Non-Federal entities in States
receiving a waiver under paragraph (1) and how these
amounts were used.
``(B) With respect to States receiving a waiver
under paragraph (1), a description of the percentage of
the grant that is expended on providing each of the
services or activities described in--
``(i) paragraphs (1) and (2) of section
1501(a); and
``(ii) paragraphs (3) through (6) of
section 1501(a).
``(C) A description of the number of States
receiving waivers under paragraph (1) annually.
``(D) With respect to States receiving a waiver
under paragraph (1), a description of--
``(i) the number of women receiving
services under paragraphs (1), (2), and (3) of
section 1501(a) in programs before and after
the granting of such waiver; and
``(ii) the average annual level of State
fiscal expenditures for the services and
activities described in paragraphs (1) and (2)
of section 1501(a) for the year preceding the
first year for which the waiver was granted.
``(4) Limitation.--Amounts to which a waiver applies under
this subsection shall not be used to increase the number of
salaried employees.
``(5) Definitions.--In this subsection:
``(A) Indian tribe.--The term `Indian tribe' has
the meaning given the term in section 4 of the Indian
Health Care Improvement Act (25 U.S.C. 1603).
``(B) Tribal organization.--The term `tribal
organization' has the meaning given the term in section
4 of the Indian Health Care Improvement Act.
``(C) State.--The term `State' means each of the
several States of the United States, the District of
Columbia, the Commonwealth of Puerto Rico, American
Samoa, the Commonwealth of the Northern Mariana
Islands, the Republic of the Marshall Islands, the
Federated States of Micronesia, the Republic of Palau,
an Indian tribe, and a tribal organization.
``(6) Sunset.--The Secretary may not grant a waiver or
extension under this subsection after September 30, 2012.'';
(3) in section 1508--
(A) in subsection (a), by striking ``evaluations of
the extent to which'' and all that follows through the
period and inserting: ``evaluations of--
``(1) the extent to which States carrying out such programs
are in compliance with section 1501(a)(2) and with section
1504(c); and
``(2) the extent to which each State receiving a grant
under this title is in compliance with section 1502, including
identification of--
``(A) the amount of the non-Federal contributions
by the State for the preceding fiscal year,
disaggregated according to the source of the
contributions; and
``(B) the proportion of such amount of non-Federal
contributions relative to the amount of Federal funds
provided through the grant to the State for the
preceding fiscal year.''; and
(B) in subsection (b), by striking ``not later than
1 year after the date on which amounts are first
appropriated pursuant to section 1509(a), and annually
thereafter'' and inserting ``not later than 1 year
after the date of the enactment of the National Breast
and Cervical Cancer Early Detection Program
Reauthorization of 2007, and annually thereafter''; and
(4) in section 1510(a)--
(A) by striking ``and'' after ``$150,000,000 for
fiscal year 1994,''; and
(B) by inserting ``, $225,000,000 for fiscal year
2008, $245,000,000 for fiscal year 2009, $250,000,000
for fiscal year 2010, $255,000,000 for fiscal year
2011, and $275,000,000 for fiscal year 2012'' before
the period at the end.
Calendar No. 100

110th CONGRESS

1st Session

S. 624

_______________________________________________________________________

A BILL

To amend the Public Health Service Act to provide waivers relating to
grants for preventive health measures with respect to breast and
cervical cancers.

_______________________________________________________________________

March 29, 2007

Reported with an amendment