[110th Congress Public Law 18]
[From the U.S. Government Printing Office]


[DOCID: f:publ018.110]

[[Page 79]]

      NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION PROGRAM 
                       REAUTHORIZATION ACT OF 2007

[[Page 121 STAT. 80]]

Public Law 110-18
110th Congress

                                 An Act


 
 To amend the Public Health Service Act to provide waivers relating to 
    grants for preventive health measures with respect to breast and 
        cervical cancers. <<NOTE: Apr. 20, 2007 -  [H.R. 1132]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress <<NOTE: National Breast and 
Cervical Cancer Early Detection Program Reauthorization Act of 2007. 42 
USC 201 note.>> assembled,
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 <<NOTE: 42 USC 300k.>> 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 <<NOTE: 42 USC 300m.>> 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--

[[Page 121 STAT. 81]]

                          ``(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);

[[Page 121 STAT. 82]]

                          ``(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

[[Page 121 STAT. 83]]

                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 <<NOTE: 42 USC 300n-4.>> 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) <<NOTE: Deadline.>> 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 <<NOTE: 42 USC 300n-5.>> 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.

    Approved April 20, 2007.

LEGISLATIVE HISTORY--H.R. 1132 (S. 624):
---------------------------------------------------------------------------

HOUSE REPORTS: No. 110-76 (Comm. on Energy and Commerce).
CONGRESSIONAL RECORD, Vol. 153 (2007):
            Mar. 27, considered and passed House.
            Mar. 29, considered and passed Senate.
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 43 (2007):
            Apr. 20, Presidential remarks.

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