[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