49–006 

109TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 109–705 

NATIONAL BREAST AND CERVICAL CANCER EARLY 

DETECTION PROGRAM REAUTHORIZATION ACT OF 2006 

SEPTEMBER 29, 2006.—Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 

Mr. BARTON of Texas, from the Committee on Energy and 

Commerce, submitted the following 

R E P O R T 

[To accompany H.R. 5472] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Energy and Commerce, to whom was referred 

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, having considered the same, 

report favorably thereon with an amendment and recommend that 

the bill as amended do pass. 

CONTENTS 

Page 

Amendment .............................................................................................................. 2 

Purpose and Summary ............................................................................................ 3 

Background and Need for Legislation .................................................................... 3 

Hearings ................................................................................................................... 5 

Committee Consideration ........................................................................................ 5 

Committee Votes ...................................................................................................... 6 

Committee Oversight Findings ............................................................................... 8 

Statement of General Performance Goals and Objectives .................................... 8 

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 8 

Earmark ................................................................................................................... 8 

Committee Cost Estimate ....................................................................................... 8 

Congressional Budget Office Estimate ................................................................... 8 

Federal Mandates Statement ................................................................................. 9 

Advisory Committee Statement .............................................................................. 9 

Constitutional Authority Statement ...................................................................... 9 

Applicability to Legislative Branch ........................................................................ 10 

Section-by-Section Analysis of the Legislation ...................................................... 10 

Changes in Existing Law Made by the Bill, as Reported ..................................... 10 


hmoore on PROD1PC68 with HMRPT
2 

AMENDMENT

The amendment is as follows: 

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 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). 

‘‘(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). 


hmoore on PROD1PC68 with HMRPT
3 

‘‘(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. 

PURPOSE AND SUMMARY

The purpose of H.R. 5472, the National Breast and Cervical 

Early Detection Reauthorization Act of 2006, is to reauthorize the 

National Breast and Cervical Early Detection Program. In addition 

to reauthorizing the program, the bill would grant the Secretary of 

the Department of Health and Human Services (HHS) the authority to waive certain requirements, allowing grantees to expend 

more funding on education and outreach activities. Such waivers 

may be granted as long as certain conditions ensuring the 

leveraging of private funds and maintaining or expanding the number of women screened is met. 

BACKGROUND AND NEED FOR LEGISLATION

Established by Congress in 1991, the National Breast and Cervical Early Detection Reauthorization Program (NBCCEDP) provides free and low-cost breast and cervical cancer screenings to 

low-income, minority, or uninsured women. Following Federal clinical guidelines, the program targets women ages 18 to 64 for cervical cancer screening and ages 40 to 64 for breast cancer screening. Services offered by the program include clinical breast examinations, mammograms, Papanikolaou or ‘‘Pap’’ tests, surgical consultations, and diagnostic testing. Administered by the Centers for 

Disease Control and Prevention (CDC), the NBCCEDP operates in 

all 50 States, four U.S. territories, the District of Columbia, and 13 

American Indian and Alaska Native organizations. The NBCCEDP 

also works with local partners, including private charitable and 

non-profit organizations, which provide matching funds for screening, education, outreach, case management, and treatment services. 

According to the CDC, breast cancer is the second most commonly diagnosed cancer in the United States. It is second only to 

lung cancer as the most common cause of death among women. Yet 

breast cancer mortality has steadily declined since the late 1980s. 

Experts attribute much of the decline to increased mammography 

screening. It is estimated that timely mammography screening of 

women over 40 could prevent between 13 to 15 percent of all 

deaths from breast cancer. When breast cancer is detected early, 

while still confined to the breast, the five-year survival rate is more 

than 95 percent. 

Similarly, cervical cancer was once the leading cause of death for 

women in the United States. Since the 1950s, however, there has 

been a 90 percent reduction in the mortality rate for cervical cancer. The National Cancer Institute of the National Institutes of 


hmoore on PROD1PC68 with HMRPT
4 

Health has attributed this reduction to effective Pap smear screening. 

While recent international comparisons have shown that the 

United States healthcare system performs well in the area of 

breast and cervical cancer screening, diagnosis, and treatment, 

when compared with other industrialized nations, significant gaps 

remain. For example, studies conducted by the Institute of Medicine have shown that low-income women have lower screening 

rates, are 41 percent more likely to be diagnosed with late-stage 

breast cancer, and three times more likely to die from breast cancer. According to the 2000 National Health Interview Survey, 

breast cancer screening rates are also lower than the national average among African American women, American Indian or Alaska 

Native women, Asian, Hispanic, Latino women. The survey also reports that only 38 percent of uninsured women interviewed said 

they had received a mammogram within the last two years, and 

only 35 percent of women with no usual source of health care reported having received a mammogram within the last two years. 

In recognition of the clear value of breast and cervical cancer 

screenings in reducing mortality from these diseases, the 

NBCCEDP is part of a multi-faceted effort to provide access to 

those women at highest risk. Since 1991, the NBCCEDP has served 

over 2.5 million women, provided over 5.8 million screening examinations including more than 2.8 million mammograms, and diagnosed more than 22,000 breast cancers and 1,500 cervical cancers. 

The NBCCEDP currently performs screenings on more than 

600,000 women annually. Partnering with State, local, and private 

entities, the NBCCEDP also provides education and outreach services to diverse populations of women. Research indicates that racial 

and ethnic minority women are less likely to have access to information about breast cancer or the financial resources to pay for important health services, including mammograms. Thus, the 

NBCCEDP makes a special effort to target racial and ethnic minority women for screening, outreach, and education efforts. As a result, over half of all women screened by the program are ethnic and 

racial minority women. 

In 2000, Congress passed the Breast and Cervical Cancer Treatment and Prevention Act. This legislation gave States the option to 

provide Medicaid coverage for treatment of women diagnosed with 

cancer through the NBCCEDP. In 2002, Congress passed the Native American Breast and Cervical Cancer Treatment Technical 

Amendment Act, which added Native American women to the optional Medicaid eligibility category. Currently, all 50 States plus 

the District of Columbia have elected this option. 

Under current law, funded programs must spend at least 60 percent of the cooperative agreement funds awarded on screening, referral, and follow-up services. The remaining 40 percent of funds 

awarded may be allocated toward other infrastructure development 

activities, including public education, professional education, quality assurance, and surveillance and evaluation efforts. In addition, 

current law places an overall cap of 10 percent on administrative 

expenses to carry out all aspects of the programs. 

While the emphasis on service provision required by the 60/40 

split is appropriate for the vast majority of grantees, in programs 

serving smaller populations, unique challenges exist in impleVerDate Aug 31 2005 02:29 Oct 05, 2006 Jkt 049006 PO 00000 Frm 00004 Fmt 6659 Sfmt 6602 E:\HR\OC\HR705.XXX HR705

hmoore on PROD1PC68 with HMRPT
5 

menting the required 60/40 split under existing law. The cap on 

program activities that are not administrative, particularly outreach and client recruitment, has made it difficult to reach some 

eligible women, especially in rural States. 

H.R. 5472, the National Breast and Cervical Cancer Early Detection Program Reauthorization Act of 2006, would reauthorize this 

program for five years and allow for a grant requirement waiver. 

H.R. 5472 would amend current law to allow for a waiver of the 

60/40 requirement. The bill would require that programs requesting a waiver provide to the Secretary of Health and Human Services justification and documentation that the number of women 

who receive preventive health and early detection services would 

not be reduced in any way. For the small number of programs that 

would likely apply for and receive the waiver, added flexibility 

would allow programs to leverage their partnerships with private 

entities and maximize the donation of clinical services. The flexibility granted under the waiver would also allow more Federal resources to be directed towards ensuring that all program components are well implemented and managed. 

Since the program’s inception in 1991, the NBCCEDP has contributed to an 18 percent increase in mammography use among 

women over age 50. The Committee generally affirms the recommendation of the Institute of Medicine, the U.S. Department of 

Health and Human Services through its Trans-HHS Cancer Health 

Disparities Progress Review Group, and such patient advocacy organizations such as the American Cancer Society and the Susan G. 

Komen Breast Cancer Foundation, that increased funds for the 

NBCCEDP are justified so that more women may have access to 

these vital cancer screening services. As a result, the bill provides 

an increase in the program’s authorized funding level for fiscal 

years 2007 through 2011. 

Finally, under Section 1502 of the Public Health Service Act, 

States requesting NBCCEDP grant funds must make non-Federal 

contributions toward the program costs. States may fulfill the 

match requirement with cash or in-kind contributions. The Committee is aware that CDC does not currently collect information on 

grantees as to whether or not matching funds are the result of 

State appropriations. The Committee directs CDC to collect additional data from grantees on the sources and types of matching 

funds and to include an analysis of those data in their annual report to Congress. 

HEARINGS

The Committee on Energy and Commerce has not held hearings 

on the legislation. 

COMMITTEE CONSIDERATION

On Wednesday, September 27, 2006, the full Committee met in 

open markup session and ordered H.R. 5472 favorably reported to 

the House, amended, by a recorded vote of 45 yeas and 0 nays, a 

quorum being present. 


hmoore on PROD1PC68 with HMRPT
6 

COMMITTEE VOTES

Clause 3(b) of rule XIII of the Rules of the House of Representatives requires the Committee to list the record votes on the motion 

to report legislation and amendments thereto. There were no recorded votes taken on amendments offered to the measure. A motion by Mr. Barton to order H.R. 5472 favorably reported to the 

House, amended, was agreed to by a record vote of 45 yeas and 0 

nays. 


hmoore on PROD1PC68 with HMRPT
7 


hmoore on PROD1PC68 with HMRPTInsert graphic folio 7 here HR705.001
8 

COMMITTEE OVERSIGHT FINDINGS

Pursuant to clause 3(c)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee has not held oversight or legislative hearings on this legislation. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

The general goals and objectives of H.R. 5472 are to update and 

reauthorize the NBCCEDP program, granting the program increased flexibility to continue to provide vital cancer screening and 

referral services. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

In compliance with clause 3(c)(2) of rule XIII of the Rules of the 

House of Representatives, the Committee finds that H.R. 5472, the 

National Breast and Cervical Cancer Early Detection Program Reauthorization Act of 2006, would result in no new or increased 

budget authority, entitlement authority, or tax expenditures or revenues. 

EARMARK

In compliance with H. Res. 1000 as passed the House of Representatives on September 14, 2006, the Committee finds that H.R. 

5472, the National Breast and Cervical Cancer Early Detection 

Program Reauthorization Act of 2006, contains no earmarks. 

COMMITTEE COST ESTIMATE

The Committee adopts as its own the cost estimate prepared by 

the Director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

CONGRESSIONAL BUDGET OFFICE ESTIMATE

Pursuant to clause 3(c)(3) of rule XIII of the Rules of the House 

of Representatives, the following is the cost estimate provided by 

the Congressional Budget Office pursuant to section 402 of the 

Congressional Budget Act of 1974: 

U.S. CONGRESS, CONGRESSIONAL BUDGET OFFICE, Washington, DC, September 28, 2006. 

Hon. JOE BARTON, 

Chairman, Committee on Energy and Commerce, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 5472, the National Breast 

and Cervical Cancer Early Detection Program Reauthorization Act 

of 2006. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Tim Gronniger. 

Sincerely, 

DONALD B. MARRON, 

Acting Director. 


hmoore on PROD1PC68 with HMRPT
9 

Enclosure. 

H.R. 5472—National Breast and Cervical Cancer Early Detection 

Program Reauthorization Act of 2006 

H.R. 5472 would modify the Public Health Service Act to authorize funding for breast and cervical cancer detection programs. It 

would authorize the appropriation of $250 million a year for fiscal 

years 2007 through 2011. The bill also would allow the Secretary 

of Health and Human Services to waive conditions of grants to 

states under certain circumstances. CBO estimates that implementing H.R. 5472 would cost $98 million in 2007 and about $1 billion over the 2007–2011 period, assuming that the authorized 

amounts are appropriated and that spending for the specified activities follows historical patterns. 

H.R. 5472 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act. In some 

cases it would ease the conditions of grants that states receive for 

programs to detect breast and cervical cancer. H.R. 5472 would not 

affect direct spending or receipts. 

The estimated budgetary impact of H.R. 5472 is shown in the following table. The costs of this legislation fall within budget function 550 (health). 

By fiscal year, in millions of dollars— 

2006 2007 2008 2009 2010 2011 

SPENDING SUBJECT TO APPROPRIATION 

Spending Under Current Law: 

Budget Authority a ........................................................................... 202 0 0 0 0 0 

Estimated Outlays ........................................................................... 202 119 29 7 2 0 

Proposed Changes: 

Estimated Authorization Level ......................................................... 0 250 250 250 250 250 

Estimated Outlays ........................................................................... 0 98 212 239 245 248 

Spending Under H.R. 5472: 

Estimated Authorization Level a ...................................................... 202 250 250 250 250 250 

Estimated Outlays ........................................................................... 202 217 241 246 247 248 

a The 2006 level is the amount allocated to the screening program for breast and cervical cancer. 

The CBO staff contact for this estimate is Tim Gronniger. 

This estimate was approved by Robert A. Sunshine, Assistant Director for Budget Analysis. 

FEDERAL MANDATES STATEMENT

The Committee adopts as its own the estimate of Federal mandates prepared by the Director of the Congressional Budget Office 

pursuant to section 423 of the Unfunded Mandates Reform Act. 

ADVISORY COMMITTEE STATEMENT

No advisory committees within the meaning of section 5(b) of the 

Federal Advisory Committee Act were created by this legislation. 

CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee finds that the Constitutional authority for this legislation is provided in Article I, section 8, clause 

3, which grants Congress the power to regulate commerce with foreign nations, among the several States, and with the Indian tribes. 


hmoore on PROD1PC68 with HMRPT
10 

APPLICABILITY TO LEGISLATIVE BRANCH

The Committee finds that the legislation does not relate to the 

terms and conditions of employment or access to public services or 

accommodations within the meaning of section 102(b)(3) of the Congressional Accountability Act. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title 

Section 1 establishes the short title of the Act as the ‘‘National 

Breast and Cervical Cancer Early Detection Program Reauthorization Act of 2006’’. 

Section 2. National Breast and Cervical Cancer Early Detection 

Program 

Section 2 of the bill amends Title XV of the Public Health Service 

Act by updating the year in current law respecting the existing coordinating committee regarding year 2000 health objectives from 

2000 health objectives to year 2020 health objectives. 

Section 2 provides that the Secretary of the Department of 

Health and Human Services may waive the 60/40 funding requirement for grantees if the following conditions apply: (1) the State 

will use the waiver to leverage private funds; (2) keeping the 

60/40 requirement in place will result in a barrier to women seeking services; (3) granting the waiver will not reduce the number of 

women receiving screening services; and (4) granting the waiver 

will not adversely affect the quality of services. 

Section 2 provides that waivers shall last for two years. The Secretary may grant a renewal of a waiver for an additional two years 

if the following applies: (1) the State will use the waiver to leverage 

private funds; (2) without a waiver extension, a barrier to eligible 

women will result; (3) the waiver has not reduced the number of 

women receiving services; and (4) the waiver has not adversely affected the quality of services available. 

Section 2 also includes reporting requirements to ensure that the 

waivers are achieving their intended results. To this end, HHS will 

include the following in its required reports: (1) a description of the 

total amount of dollars leveraged annually from private entities in 

States that receive a waiver; (2) for States that receive waivers, the 

percentage of the grant that’s spent on each service must be specified; (3) States participating in the waiver must be listed; and (4) 

States that receive waivers must include a description of the number of women receiving services. 

Section 2 updates priority language for low-income women to include outreach and education efforts. 

Section 2 authorizes for fiscal years 2007 to 2011, the program to be funded at $250,000,000 each year. 

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italic, 

existing law in which no change is proposed is shown in roman): 


hmoore on PROD1PC68 with HMRPT
11 

PUBLIC HEALTH SERVICE ACT 

* * * * * * * 

TITLE XV—PREVENTIVE HEALTH MEASURES WITH RESPECT TO BREAST AND 

CERVICAL CANCERS 

SEC. 1501. ESTABLISHMENT OF PROGRAM OF GRANTS TO STATES. 

(a) * * * 

* * * * * * * 

(d) COORDINATING COMMITTEE REGARDING YEAR ø2000¿ 2020 

HEALTH OBJECTIVES.—The Secretary, acting through the Director 

of the Centers for Disease Control and Prevention, shall establish 

a committee to coordinate the activities of the agencies of the Public Health Service (and other appropriate Federal agencies) that 

are carried out toward achieving the objectives established by the 

Secretary for reductions in the rate of mortality from breast and 

cervical cancer in the United States øby the year 2000¿ by the year 

2020. Such committee shall be comprised of Federal officers or employees designated by the heads of the agencies involved to serve 

on the committee as representatives of the agencies, and such representatives from other public or private entities as the Secretary 

determines to be appropriate. 

* * * * * * * 

SEC. 1503. REQUIREMENTS WITH RESPECT TO TYPE AND QUALITY OF 

SERVICES. 

(a) * * * 

* * * * * * * 

(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—


hmoore on PROD1PC68 with HMRPT
12 

(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). 

(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. 

SEC. 1504. ADDITIONAL REQUIRED AGREEMENTS. 

(a) PRIORITY FOR LOW-INCOME WOMEN.—The Secretary may not 

make a grant under section 1501 unless the State involved agrees 

that low-income women will be given priority in the provision of 

services and activities øpursuant to paragraphs (1) and (2) of secVerDate Aug 31 2005 02:29 Oct 05, 2006 Jkt 049006 PO 00000 Frm 00012 Fmt 6659 Sfmt 6601 E:\HR\OC\HR705.XXX HR705

hmoore on PROD1PC68 with HMRPT
13 

tion 1501(a)¿ pursuant to paragraphs (1), (2), and (3) of section 

1501(a). 

* * * * * * * 

SEC. 1510. FUNDING FOR GENERAL PROGRAM. 

(a) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of carrying out this title, there are authorized to be appropriated 

$50,000,000 for fiscal year 1991, such sums as may be necessary 

for each of the fiscal years 1992 and 1993, $150,000,000 for fiscal 

year 1994, øand¿ such sums as may be necessary for each of the 

fiscal years 1995 through 2003, and $250,000,000 for each of fiscal 

years 2007 through 2011. 

* * * * * * * 

Æ 


hmoore on PROD1PC68 with HMRPT