H. R. 1132

One Hundred Tenth Congress

of the

United States of America 

AT THE FIRST SESSION 

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 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—
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‘‘(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); 
H. R. 1132—3

‘‘(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 
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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.