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[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1132 Enrolled Bill (ENR)]

        H.R.1132

                       One Hundred Tenth Congress

                                 of the

                        United States of America

          Begun and held at the City of Washington on Thursday,
            the fourth day of January, two thousand and seven

                                 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 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--
                ``(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);
                ``(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 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.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
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