[Congressional Record (Bound Edition), Volume 152 (2006), Part 18]
[House]
[Pages 23385-23387]
[From the U.S. Government Publishing Office, www.gpo.gov]




      NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM 
                      REAUTHORIZATION ACT OF 2006

  Mr. BARTON of Texas. Mr. Speaker, I ask unanimous consent to take 
from the Speaker's table the bill (H.R. 5472) to amend the Public 
Health Service Act to provide waivers relating to grants for preventive 
health measures with respect to breast and cervical cancers, and ask 
for its immediate consideration in the House.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  The Clerk read the bill, as follows:

                               H.R. 5472

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``National Breast and Cervical 
     Cancer Early Detection Program Reauthorization Act of 2006''.

     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 may waive the requirements 
     of paragraphs (1) and (4) of subsection (a) if the Secretary 
     finds that--
       ``(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
       ``(ii) the application of such requirements would result in 
     a barrier to the participation of qualifying women in the 
     services or activities described in paragraphs (1) and (2) of 
     section 1501(a);
       ``(B) granting such a waiver to the State will not reduce 
     the number of women in the State who receive any of the 
     services or activities described in paragraphs (1) and (2) of 
     section 1501(a), including screening procedures for both 
     breast and cervical cancers; and
       ``(C) granting such a waiver to the State will not 
     adversely affect the quality of any 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 of 2 years; and
       ``(ii) upon request of a State, may extend a waiver for 
     additional 2-year periods in accordance with subparagraph 
     (B).

[[Page 23386]]

       ``(B) Additional periods.--The Secretary, upon the request 
     of a State that has received a waiver under paragraph (1), 
     shall, at the end of each 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 finds that--
       ``(i)(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
       ``(II) without an extension of the waiver, the application 
     of the requirements of paragraphs (1) and (4) of subsection 
     (a) would result in a barrier to the participation of 
     qualifying women in the services or activities described in 
     paragraphs (1) and (2) of section 1501(a);
       ``(ii) the waiver has not reduced, and granting the waiver 
     extension will not reduce, the number of women in the State 
     who receive any of the services or activities described in 
     paragraphs (1) and (2) of section 1501(a); and
       ``(iii) the waiver has not adversely affected, and granting 
     the waiver extension will not adversely affect, the quality 
     in the State of any of the services or activities described 
     in paragraphs (1) and (2) of section 1501(a).
       ``(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 private entities in States receiving 
     a waiver under this subsection and how these amounts were 
     used.
       ``(B) With respect to States receiving a waiver under this 
     subsection, a description of--
       ``(i) the percentage of the grant that is expended on 
     services or activities described in paragraphs (1) and (2) of 
     section 1501(a); and
       ``(ii) the percentage of the grant that is expended on 
     services or activities described in paragraphs (3) through 
     (6) of section 1501(a).
       ``(C) A description of the number of States receiving 
     waivers under this subsection annually.
       ``(D) With respect to States receiving a waiver under this 
     subsection, a description of 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.'';
       (3) in section 1504(a), by striking ``pursuant to 
     paragraphs (1) and (2) of section 1501(a)'' and inserting 
     ``pursuant to paragraphs (1), (2), and (3) of section 
     1501(a)''; and
       (4) in section 1510(a)--
       (A) by striking ``and'' after ``$150,000,000 for fiscal 
     year 1994,''; and
       (B) by inserting ``, and $250,000,000 for each of fiscal 
     years 2007 through 2011'' before the period at the end.


 Amendment in the Nature of a Substitute Offered by Mr. Barton of Texas

  Mr. BARTON of Texas. Mr. Speaker, I offer an amendment in the nature 
of a substitute.
  The Clerk read as follows:

       Amendment in the nature of a substitute offered by Mr. 
     Barton of Texas:
       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``National Breast and Cervical 
     Cancer Early Detection Program Reauthorization Act of 2006''.

     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, 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--
       ``(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
       ``(ii) the application of such requirement would result in 
     a barrier to the enrollment of qualifying women;
       ``(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;
       ``(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;
       ``(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
       ``(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).
       ``(2) Duration of waiver.--
       ``(A) In general.--In granting waivers under paragraph (1), 
     the Secretary--
       ``(i) shall grant such waivers for a period of 2 years; and
       ``(ii) upon request of a State, may extend a waiver for an 
     additional 2-year period 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 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--
       ``(i)(I) without an extension of the waiver, there will be 
     a barrier to the enrollment of qualifying women; or
       ``(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);
       ``(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);
       ``(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
       ``(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.
       ``(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 private 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.'';
       (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

[[Page 23387]]

     Cervical Cancer Early Detection Program Reauthorization of 
     2006, 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 2007, 
     $245,000,000 for fiscal year 2008, $250,000,000 for fiscal 
     year 2009, $255,000,000 for fiscal year 2010, and 
     $275,000,000 for fiscal year 2011'' before the period at the 
     end.

  The SPEAKER pro tempore (during the reading). Without objection, the 
Clerk will dispense with the reading.
  Mr. PALLONE. Mr. Speaker, if I could just reserve. My concern at this 
point is whether or not the legislation before us, as amended, with the 
amendment the chairman just mentioned, is in fact the version that I 
have that is timed at 12:50 a.m.
  The SPEAKER pro tempore. Will the gentleman from Texas answer that?
  Mr. BARTON of Texas. My understanding is the version they have is the 
version the Clerk has, the 12:50 a.m. version.
  Mr. PALLONE. The 12:50 a.m. is the amendment that you just asked us 
to consider?
  Mr. BARTON of Texas. Yes, sir.
  Mr. PALLONE. All right. Thank you. I have no objection.
  The SPEAKER pro tempore. The gentleman withdraws his reservation.
  The amendment was agreed to.
  The bill was ordered to be engrossed and read a third time, was read 
the third time, and passed, and a motion to reconsider was laid on the 
table.

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