PUBLIC LAW 110–18—APR. 20, 2007

NATIONAL BREAST AND CERVICAL CANCER

EARLY DETECTION PROGRAM

REAUTHORIZATION ACT OF 2007

121 STAT. 80 PUBLIC LAW 110–18—APR. 20, 2007

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.

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 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 followup 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—

42 USC 300m.

42 USC 300k.

National Breast

and Cervical

Cancer Early

Detection

Program

Reauthorization

Act of 2007.

42 USC 201 note.

Apr. 20, 2007

[H.R. 1132]

PUBLIC LAW 110–18—APR. 20, 2007 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);

121 STAT. 82 PUBLIC LAW 110–18—APR. 20, 2007

‘‘(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

PUBLIC LAW 110–18—APR. 20, 2007 121 STAT. 83

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.

Æ

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.

Approved April 20, 2007.

42 USC 300n–5.

Deadline.

42 USC 300n–4.