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

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 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.

            Passed the House of Representatives December 9 (legislative 
      day, December 8), 2006.

            Attest:

                                                 KAREN L. HAAS,

                                                                 Clerk.

Summary: National Breast and Cervical Cancer Early Detection Program Reauthorization Act of 2006 - Amends the Public Health Service Act to change from 2000 to 2020 the target year for achieving the objectives established by the Secretary of Health and Human Services for reductions in the rate of mortality from breast and cervical cancer in the United States for the committee coordinating Public Health Service activities. Directs the Secretary to establish a demonstration project which allows the Secretary, acting through the Director of the Centers for Disease Control and Prevention (CDC), to waive requirements for awarding breast and cervical cancer grants that require 60 of grant funds to be spent on screening and referrals for medical treatments and no more than 40 to be spent on other activities for not more than five states, if: (1) the state involved will use the waiver to leverage private funds to supplement screening and referral services or the application of such requirements would result in a barrier to the enrollment of women. (2) the state involved provides assurance that the state will annually demonstrate how it will use the waiver to maintain or expand the level of screening and follow-up services provided. (3) 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. (4) the Secretary finds that granting such a waiver to a state will not reduce the number of women in the state who receive such services, including screening for both breast and cervical cancers. And (5) the Secretary finds that granting such a waiver to a state will not adversely affect the quality of such services. Requires the Secretary to grant such waivers for a period of two years. Allows the Secretary to extend a waiver, upon request of a state, for additional two-year periods if the Secretary reviews performance under the waiver and finds that the waiver requirements are and have been met. Requires the Secretary to include as part of the evaluations of the activities carried out pursuant to breast and cervical cancer grants: (1) the total amount of dollars leveraged annually from private entities in states receiving a waiver and how these amounts were used. (2) for states receiving a waiver, the percentages of the grant expended on screening and referral services and on other services or activities, (3) the number of states receiving waivers annually. (4) the number of women receiving screening and referral services in programs before and after the granting of a waiver. (5) the average annual level of state fiscal expenditures for such services for the year preceding the grant of the waiver. And (6) the amount of non-federal contributions by the state according to source and the proportion of non-federal funds to federal funds. Prohibits the use of amounts to which a waiver applies to increase the number of salaried employees. Authorizes appropriations for breast and cervical cancer grants from FY2007-FY2011.