II

103D CONGRESS

1ST SESSION S. 1454

To amend the Public Health Service Act with respect to research on breast

cancer.

IN THE SENATE OF THE UNITED STATES

SEPTEMBER 14 (legislative day, SEPTEMBER 7), 1993

Mrs. BOXER introduced the following bill; which was read twice and referred

to the Committee on Labor and Human Resources

A BILL

To amend the Public Health Service Act with respect to

research on breast cancer.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘National Breast Can5 cer Strategy Act of 1993’’.
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1 TITLE I—ESTABLISHMENT OF

2 OFFICE OF BREAST CANCER

3 AND NATIONAL BREAST CAN4 CER COMMISSION

5 SEC. 101. OFFICE OF BREAST CANCER.

6 Title XVII of the Public Health Service Act (42

7 U.S.C. 300uu et seq.) is amended by adding at the end

8 the following new section:

9 ‘‘SEC. 1709. ESTABLISHMENT OF OFFICE OF BREAST CAN10 CER.

11 ‘‘(a) IN GENERAL.—There is established an Office of

12 Breast Cancer within the Office of the Assistant Secretary

13 for Health. The Office shall have a Director who shall be

14 appointed by the Secretary. The Secretary, acting through

15 the Director, shall carry out this section.

16 ‘‘(b) DUTIES.—The Secretary shall coordinate, in

17 conjunction with the Director of the National Cancer In18 stitute, the activities of the Institute relating to breast

19 cancer with similar activities of other agencies of the Fed20 eral Government, including the other agencies of the Na21 tional Institutes of Health, and with similar activities of

22 other public entities and of private entities.’’.
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1 SEC. 102. ESTABLISHMENT OF NATIONAL BREAST CANCER

2 COMMISSION.

3 Title XVII of the Public Health Service Act (42

4 U.S.C. 300uu et seq.), as amended by section 101, is

5 amended by adding at the end the following new section:

6 ‘‘SEC. 1710. NATIONAL BREAST CANCER COMMISSION.

7 ‘‘(a) ESTABLISHMENT.—There is established a com8 mission to be known as the ‘National Breast Cancer Com9 mission’ (in this section referred to as the ‘Commission’).

10 ‘‘(b) STUDY.—The Commission shall conduct a study

11 on current efforts in both the public and private sectors

12 relating to the prevention, early detection, treatment, edu13 cation, and research relating to breast cancer.

14 ‘‘(c) REPORT.—Not later than 1 year after the date

15 on which the initial appointments of the members have

16 been completed under subsection (d), the Commission

17 shall submit to the President and the Congress a report

18 containing—

19 ‘‘(1) the results of the study conducted under

20 subsection (b); and

21 ‘‘(2) recommendations relating to such study.

22 ‘‘(d) NUMBER AND APPOINTMENT.—

23 ‘‘(1) APPOINTMENT.—The Commission shall be

24 composed of 15 members as follows:

25 ‘‘(A) 5 members shall be appointed by the

26 President—
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1 ‘‘(i) 3 of whom shall be—

2 ‘‘(I) the Secretary of Health and

3 Human Services;

4 ‘‘(II) the Secretary of Veterans

5 Affairs; and

6 ‘‘(III) the Secretary of Defense;

7 who shall be nonvoting members, except

8 that, in the case of a tie vote by the Com9 mission, the Secretary of Health and

10 Human Services shall be a voting member;

11 and

12 ‘‘(ii) 2 of whom shall be selected from

13 the general public on the basis of such in14 dividuals being specially qualified to serve

15 on the Commission by reason of their edu16 cation, training, or experience.

17 ‘‘(B) 5 members shall be appointed by the

18 Speaker of the House of Representatives on the

19 joint recommendation of the Majority and Mi20 nority Leaders of the House of Representatives.

21 ‘‘(C) 5 members shall be appointed by the

22 President pro tempore of the Senate on the

23 joint recommendation of the Majority and Mi24 nority Leaders of the Senate.
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1 ‘‘(2) CONGRESSIONAL COMMITTEE REC2 OMMENDATIONS.—In making appointments under

3 subparagraphs (B) and (C) of paragraph (1), the

4 Majority and Minority leaders of the House of Rep5 resentatives and the Senate shall duly consider the

6 recommendations of the Chairmen and Ranking Mi7 nority Members of committees with jurisdiction over

8 laws contained in chapter 17 of title 38, United

9 States Code (relating to veterans’ health care), title

10 XIX of the Social Security Act (42 U.S.C. 1901 et

11 seq.) (relating to Medicaid), and the Public Health

12 Service Act (42 U.S.C. 201 et seq.) (relating to the

13 Public Health Service).

14 ‘‘(3) REQUIREMENTS OF APPOINTMENTS.—The

15 Majority and Minority leaders of the Senate and the

16 House of Representatives shall—

17 ‘‘(A) select individuals who are specially

18 qualified to serve on the Commission by reason

19 of their education, training, or experience; and

20 ‘‘(B) engage in consultations for the pur21 pose of ensuring that the expertise of the 10

22 members appointed by the Speaker of the

23 House of Representatives and the President pro

24 tempore of the Senate shall provide as much of

25 a balance as possible and, to the greatest extent
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1 possible, cover the fields of medicine, science,

2 law, ethics, health-care and social services.

3 ‘‘(4) TERM OF MEMBERS.—Members of the

4 Commission (other than members appointed under

5 paragraph (1)(A)(i)) shall serve for the life of the

6 Commission.

7 ‘‘(5) VACANCY.—A vacancy on the Commission

8 shall be filled in the manner in which the original

9 appointment was made.

10 ‘‘(e) CHAIRMAN.—Not later than 15 days after the

11 members of the Commission are appointed, such members

12 shall select a Chairman from among the members of the

13 Commission.

14 ‘‘(f) QUORUM.—7 members of the Commission shall

15 constitute a quorum, but a lesser number may be author16 ized by the Commission to conduct hearings.

17 ‘‘(g) MEETINGS.—The Commission shall hold its 1st

18 meeting on a date specified by the Chairman. After the

19 initial meeting, the Commission shall meet at the call of

20 the Chairman or a majority of its members, but shall meet

21 at least 3 times each year during the life of the Commis22 sion.

23 ‘‘(h) PAY.—Members of the Commission who are offi24 cers or employees or elected officials of a government en-
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1 tity shall receive no additional compensation by reason of

2 their service on the Commission.

3 ‘‘(i) PER DIEM.—While away from their homes or

4 regular places of business in the performance of duties for

5 the Commission, members of the Commission shall be al6 lowed travel expenses, including per diem in lieu of sub7 sistence, at rates authorized for employees of agencies

8 under sections 5702 and 5703 of title 5, United States

9 Code.

10 ‘‘(j) DEADLINE FOR APPOINTMENT.—The members

11 of the Commission shall be appointed not later than 60

12 days after the date of the enactment of this section.

13 ‘‘(k) TERMINATION.—The Commission shall cease to

14 exist 60 days after the date on which its final report is

15 submitted under subsection (c).’’.

16 TITLE II—DUTIES OF DIRECTOR

17 OF THE NATIONAL CANCER

18 INSTITUTE RELATING TO

19 BREAST CANCER

20 SEC. 201. PROVISIONS FOR FULL FUNDING FOR NATIONAL

21 CANCER INSTITUTE WITH RESPECT TO RE22 SEARCH ON BREAST CANCER.

23 Section 408(a)(1) of the Public Health Service Act

24 (42 U.S.C. 284c(a)(1)) is amended by adding at the end

25 the following subparagraph:
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1 ‘‘(C) For the purpose of conducting and sup2 porting research on breast cancer through the Na3 tional Cancer Institute, there is authorized to be ap4 propriated for fiscal year 1994 an amount equal to

5 the sum of $300,000,000 and the amount obligated

6 by such Institute for such research for fiscal year

7 1993. For such purpose, there are authorized to be

8 appropriated such sums as may be necessary for

9 each of the fiscal years 1995 and 1996.’’.

10 SEC. 202. DUTIES OF DIRECTOR.

11 Subpart 1 of part C of title IV of the Public Health

12 Service Act (42 U.S.C. 285 et seq.) is amended by adding

13 at the end the following new section:

14 ‘‘SEC. 417. DUTIES OF DIRECTOR OF THE INSTITUTE RELAT15 ING TO BREAST CANCER RESEARCH.

16 ‘‘(a) The Director of the Institute shall conduct and

17 support biomedical and behavioral research and research

18 training, the dissemination of health information, and

19 other programs with respect to breast cancer.

20 ‘‘(b) In carrying out subsection (a), the Director of

21 the Institute shall conduct or support multidisciplinary

22 clinical research on breast cancer, including research on

23 assisting individuals with such cancers (and the families

24 of such individuals) and with responding to psychological

25 and social problems that arise as the result of the cancer.
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1 ‘‘(c)(1) The Director of the Institute shall establish

2 the Rose Kushner Scholarship Program for the purpose

3 of entering into contracts with individuals under which—

4 ‘‘(A) the Director of the Institute agrees to pro5 vide to the individuals scholarships for attendance at

6 accredited health professions schools; and

7 ‘‘(B) the individuals agree—

8 ‘‘(i) to complete the programs of education

9 for which the scholarships are provided;

10 ‘‘(ii) to complete a program of post11 graduate clinical training in oncology; and

12 ‘‘(iii) after completing a program of such

13 training, to serve as employees of the National

14 Institutes of Health, for the period described in

15 paragraph (2), in positions that are needed by

16 such Institutes in carrying out programs with

17 respect to breast cancer.

18 ‘‘(2)(A) For purposes of paragraph (1)(B)(iii), the

19 period of service for which an individual is obligated to

20 serve as an employee of the National Institutes of Health

21 is 12 months for each academic year for which the scholar22 ship under such subsection is provided.

23 ‘‘(B) The Director of the Institute may defer the obli24 gation of an individual to provide a period of service under
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1 paragraph (1)(B)(iii), if the Director determines that such

2 a deferral is appropriate.

3 ‘‘(C) For any period in which an individual provides

4 service as an employee of the National Institutes of Health

5 in satisfaction of the obligation of the individual under

6 paragraph (1)(B)(iii), the individual may be appointed as

7 such an employee without regard to the provisions of title

8 5, United States Code, relating to appointment and com9 pensation.

10 ‘‘(3)(A) The Director of the Institute may not provide

11 a scholarship under paragraph (1) for an academic year

12 unless—

13 ‘‘(i) the individual applying for the scholarship

14 has submitted to the Director a proposed academic

15 program for the year and the Director has approved

16 the program; and

17 ‘‘(ii) the individual agrees that the program will

18 not be altered without the approval of the Director.

19 ‘‘(B) The Director of the Institute may not provide

20 a scholarship under paragraph (1) for an academic year

21 unless the individual applying for the scholarship agrees

22 to maintain an acceptable level of academic standing, as

23 determined by the educational institution involved in ac24 cordance with regulations issued by the Secretary.
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1 ‘‘(4)(A) The Director of the Institute may not provide

2 a scholarship under paragraph (1) for an academic year

3 in an amount exceeding $10,000.

4 ‘‘(B) A scholarship provided under paragraph (1)

5 may be expended only for tuition expenses, other reason6 able educational expenses, and reasonable living expenses

7 incurred while attending the health professions school in8 volved.

9 ‘‘(C) In the case of a health professions school with

10 respect to which a scholarship under paragraph (1) is pro11 vided, the Director of the Institute may enter into a con12 tract with the school under which the amounts provided

13 in the scholarship for tuition and other educational ex14 penses are paid directly to the school. Payments to the

15 school under the contract may be made without regard

16 to section 3324 of title 31, United States Code.

17 ‘‘(5) The provisions of section 338E shall apply to

18 the program established in paragraph (1) to the same ex19 tent and in the same manner as such provisions apply to

20 the National Health Service Corps Loan Repayment Pro21 gram established in section 338B.

22 ‘‘(6) The Director of the Institute may not provide

23 a scholarship under paragraph (1) unless an application

24 for the scholarship is submitted to the Director and the

25 application is in such form, is made in such manner, and
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1 contains such agreements, assurances, and information as

2 the Director determines to be necessary to carry out this

3 section.

4 ‘‘(d)(1) The Director of the Institute shall, subject

5 to paragraph (2), carry out a program of entering into

6 contracts with appropriately qualified health professionals

7 under which the professionals agree to carry out activities

8 with respect to breast cancer as employees of the National

9 Institutes of Health in consideration of the Federal Gov10 ernment agreeing to pay, for each year of such service,

11 not more than $20,000 of the principal and interest of

12 the educational loans of the professionals.

13 ‘‘(2) The Director of the Institute may not enter into

14 a contract with a health professional pursuant to para15 graph (1) unless the professional has a substantial amount

16 of educational loans relative to income.

17 ‘‘(3) Except to the extent inconsistent with this sec18 tion, 338E shall apply to the program established in para19 graph (1) to the same extent and in the same manner as

20 such section applies to the National Health Service Corps

21 Loan Repayment Program established in section 338B.’’.
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1 SEC. 203. SPECIALIZED PROGRAMS OF RESEARCH EXCEL2 LENCE WITH RESPECT TO BREAST, LUNG,

3 AND PROSTATE CANCER.

4 Section 408(a)(1) of the Public Health Service Act,

5 as amended by section 201, is amended by adding at the

6 end the following subparagraph:

7 ‘‘(D)(i) For the purpose of carrying out not less

8 than 10 programs for research on breast cancer,

9 lung cancer, or prostate cancer under the programs

10 designated by the Director of the National Cancer

11 Institute as the Specialized Programs of Research

12 Excellence, there is authorized to be appropriated

13 such sums as may be necessary for each of the fiscal

14 years 1994 through 1996.

15 ‘‘(ii) With respect to the purpose described in

16 clause (i), the authorizations of appropriations es17 tablished in such clause may not be construed as

18 terminating the availability for such purpose of any

19 other authorization of appropriations (including the

20 authorization established in subparagraph (A).’’.

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