Union Calendar No. 64

103D CONGRESS

1ST SESSION H. R. 2202

[Report No. 103–120]

A BILL

To amend the Public Health Service Act to revise

and cervical cancer.ventive health measures with respect to breastand extend the program of grants relating to preJUNE 10, 1993

Reported with an amendment, committed to the Commitordered to be printed tee of the Whole House on the State of the Union, and
IB

Union Calendar No. 64

103D CONGRESS

1ST SESSION H. R. 2202

[Report No. 103–120]

To amend the Public Health Service Act to revise and extend the program

of grants relating to preventive health measures with respect to breast

and cervical cancer.

IN THE HOUSE OF REPRESENTATIVES

MAY 20, 1993

Mr. WAXMAN (for himself, Mr. BLILEY, Mr. DINGELL, Mr. MOORHEAD, Mr.

HALL of Texas, Mr. ROWLAND, Mr. TOWNS, Mr. STUDDS, Mr.

KREIDLER, Mr. BILIRAKIS, Mr. MCMILLAN, and Mr. GREENWOOD) introduced the following bill; which was referred to the Committee on Energy

and Commerce

JUNE 10, 1993

Additional sponsors: Mr. RICHARDSON, Mr. FRANKS of Connecticut, and Mr.

UPTON

JUNE 10, 1993

Reported with an amendment, committed to the Committee of the Whole

House on the State of the Union, and ordered to be printed

[Strike out all after the enacting clause and insert the part printed in italic]

[For text of introduced bill, see copy of bill as introduced on May 20, 1993]

A BILL

To amend the Public Health Service Act to revise and extend

the program of grants relating to preventive health measures with respect to breast and cervical cancer.
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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 ‘‘Breast and Cervical

5 Cancer Amendments of 1993’’.

6 SEC. 2. REVISIONS IN PROGRAM OF STATE GRANTS RE7 GARDING BREAST AND CERVICAL CANCER.

8 (a) LIMITED AUTHORITY REGARDING FOR-PROFIT

9 ENTITIES.—

10 (1) IN GENERAL.—Section 1501(b) of the Public

11 Health Service Act (42 U.S.C. 300k(b)) is amended—

12 (A) by striking ‘‘STATES.—A State’’ and all

13 that follows through ‘‘may expend’’ and inserting

14 the following: ‘‘STATES.—

15 ‘‘(1) IN GENERAL.—A State receiving a grant

16 under subsection (a) may, subject to paragraphs (2)

17 and (3), expend’’; and

18 (B) by adding at the end the following

19 paragraphs:

20 ‘‘(2) LIMITED AUTHORITY REGARDING OTHER

21 ENTITIES.—In addition to the authority established

22 in paragraph (1) for a State with respect to grants

23 and contracts, the State may provide for screenings

24 under subsection (a)(1) through entering into con25 tracts with private entities.
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1 ‘‘(3) PAYMENTS FOR SCREENINGS.—The amount

2 paid by a State to an entity under this subsection for

3 a screening procedure under subsection (a)(1) may

4 not exceed the amount that would be paid under part

5 B of title XVIII of the Social Security Act if payment

6 were made under such part for furnishing the proce7 dure to a woman enrolled under such part.’’.

8 (2) CONFORMING AMENDMENT.—Section 1505(3)

9 of the Public Health Service Act (42 U.S.C. 300n10 1(3)) is amended by inserting before the semicolon the

11 following: ‘‘(and additionally, in the case of services

12 and activities under section 1501(a)(1), with any

13 similar services or activities of private entities)’’.

14 (b) QUALITY ASSURANCE REGARDING SCREENING

15 PROCEDURES.—

16 (1) IN GENERAL.—Section 1503 of the Public

17 Health Service Act (42 U.S.C. 300m) is amended by

18 striking subsections (c) through (e) and inserting the

19 following:

20 ‘‘(c) QUALITY ASSURANCE REGARDING SCREENING

21 PROCEDURES.—The Secretary may not make a grant

22 under section 1501 unless the State involved agrees that the

23 State will, in accordance with applicable law, assure the

24 quality of screening procedures conducted pursuant to such

25 section.’’.
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1 (2) TRANSITION RULE REGARDING MAMMO2 GRAPHIES.—With respect to the screening procedure

3 for breast cancer known as a mammography, the re4 quirements in effect on the day before the date of the

5 enactment of this Act under section 1503(c) of the

6 Public Health Service Act remain in effect (for an in7 dividual or facility conducting such procedures pur8 suant to a grant to a State under section 1501 of such

9 Act) until there is in effect for the facility a certifi10 cate (or provisional certificate) issued under section

11 354 of such Act.

12 (c) STATEWIDE PROVISION OF SERVICES.—Section

13 1504(c) of the Public Health Service Act (42 U.S.C.

14 300n(c)) is amended by adding at the end the following

15 paragraph:

16 ‘‘(3) GRANTS TO TRIBES AND TRIBAL ORGANIZA17 TIONS.—

18 ‘‘(A) The Secretary, acting through the Di19 rector of the Centers for Disease Control and

20 Prevention, may make grants to tribes and tribal

21 organizations (as such terms are used in para22 graph (1)) for the purpose of carrying out pro23 grams described in section 1501(a). This title ap24 plies to such a grant (in relation to the jurisdic25 tion of the tribe or organization) to the same ex-
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1 tent and in the same manner as such title ap2 plies to a grant to a State under section 1501

3 (in relation to the jurisdiction of the State).

4 ‘‘(B) If a tribe or tribal organization is re5 ceiving a grant under subparagraph (A) and the

6 State in which the tribe or organization is lo7 cated is receiving a grant under section 1501, the

8 requirement established in paragraph (1) for the

9 State regarding the tribe or organization is

10 deemed to have been waived under paragraph

11 (2).’’.

12 (d) EVALUATIONS AND REPORTS.—Section 1508 of the

13 Public Health Service Act (42 U.S.C. 300n–4) is amend14 ed—

15 (1) in subsection (a), by adding at the end the

16 following sentence: ‘‘Such evaluations shall include

17 evaluations of the extent to which States carrying out

18 such programs are in compliance with section

19 1501(a)(2) and with section 1504(c).’’; and

20 (2) in subsection (b), by inserting before the pe21 riod the following: ‘‘, including recommendations re22 garding compliance by the States with section

23 1501(a)(2) and with section 1504(c)’’.

24 (e) ESTABLISHMENT OF COORDINATING COMMIT25 TEE.—Section 1501 of the Public Health Service Act (42
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1 U.S.C. 300k) is amended by adding at the end the following

2 subsection:

3 ‘‘(c) COORDINATING COMMITTEE REGARDING YEAR

4 2000 HEALTH OBJECTIVES.—The Secretary, acting

5 through the Director of the Centers for Disease Control and

6 Prevention, shall establish a committee to coordinate the ac7 tivities of the agencies of the Public Health Service (and

8 other appropriate Federal agencies) that are carried out to9 ward achieving the objectives established by the Secretary

10 for reductions in the incidence of breast and cervical cancer

11 in the United States by the year 2000. Such committee shall

12 be comprised of Federal officers or employees designated by

13 the heads of the agencies involved to serve on the committee

14 as representatives of the agencies, and such representatives

15 from other public or private entities as the Secretary deter16 mines to be appropriate.’’.

17 (f) TECHNICAL CORRECTIONS.—Title XV of the Public

18 Health Service Act (42 U.S.C. 300k et seq.) is amended—

19 (1) in section 1501(a), in the matter preceding

20 paragraph (1), by striking ‘‘Control,’’ and inserting

21 ‘‘Control and Prevention,’’; and

22 (2) in section 1505—

23 (A) in paragraph (3), by striking

24 ‘‘nonprivate’’ and inserting ‘‘nonprofit private’’;

25 and
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1 (B) in paragraph (4), by inserting ‘‘will’’

2 before ‘‘be used’’.

3 SEC. 3. ESTABLISHMENT OF DEMONSTRATION PROGRAM

4 OF GRANTS FOR ADDITIONAL PREVENTIVE

5 HEALTH SERVICES FOR WOMEN.

6 (a) IN GENERAL.—Title XV of the Public Health Serv7 ice Act (42 U.S.C. 300k et seq.) is amended—

8 (1) by redesignating section 1509 as section

9 1510; and

10 (2) by inserting after section 1508 the following

11 section:

12 ‘‘SEC. 1509. SUPPLEMENTAL GRANTS FOR ADDITIONAL PRE13 VENTIVE HEALTH SERVICES.

14 ‘‘(a) DEMONSTRATION PROJECTS.—In the case of

15 States receiving grants under section 1501, the Secretary,

16 acting through the Director of the Centers for Disease Con17 trol and Prevention, may make grants to not more than

18 3 such States to carry out demonstration projects for the

19 purpose of—

20 ‘‘(1) providing preventive health services in ad21 dition to the services authorized in such section, in22 cluding screenings regarding blood pressure and cho23 lesterol, and including health education;

24 ‘‘(2) providing appropriate referrals for medical

25 treatment of women receiving services pursuant to
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1 paragraph (1) and ensuring, to the extent practicable,

2 the provision of appropriate follow-up services; and

3 ‘‘(3) evaluating activities conducted under para4 graphs (1) and (2) through appropriate surveillance

5 or program-monitoring activities.

6 ‘‘(b) STATUS AS PARTICIPANT IN PROGRAM REGARD7 ING BREAST AND CERVICAL CANCER.—The Secretary may

8 not make a grant under subsection (a) unless the State in9 volved agrees that services under the grant will be provided

10 only through entities that are screening women for breast

11 or cervical cancer pursuant to a grant under section 1501.

12 ‘‘(c) APPLICABILITY OF PROVISIONS OF GENERAL PRO13 GRAM.—This title applies to a grant under subsection (a)

14 to the same extent and in the same manner as such title

15 applies to a grant under section 1501.

16 ‘‘(d) FUNDING.—

17 ‘‘(1) IN GENERAL.—Subject to paragraph (2), for

18 the purpose of carrying out this section, there are au19 thorized to be appropriated $3,000,000 for fiscal year

20 1994, and such sums as may be necessary for each of

21 the fiscal years 1995 through 1998.

22 ‘‘(2) LIMITATION REGARDING FUNDING WITH RE23 SPECT TO BREAST AND CERVICAL CANCER.—The au24 thorization of appropriations established in para25 graph (1) is not effective for a fiscal year unless the
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1 amount appropriated under section 1510(a) for the

2 fiscal year equals or exceeds the amount appropriated

3 under such section for the preceding fiscal year.’’.

4 (b) CONFORMING AMENDMENT.—Section 1510(a) of

5 the Public Health Service Act, as redesignated by subsection

6 (a)(1) of this section, is amended in the heading for the

7 section by striking ‘‘FUNDING.’’ and inserting ‘‘FUNDING

8 FOR GENERAL PROGRAM.’’.

9 SEC. 4. FUNDING FOR GENERAL PROGRAM.

10 Section 1510(a) of the Public Health Service Act, as

11 redesignated by section 3(a)(1) of this Act, is amended—

12 (1) by striking ‘‘and’’ after ‘‘1991,’’; and

13 (2) by inserting before the period the following:

14 ‘‘, $135,000,000 for fiscal year 1994, and such sums

15 as may be necessary for each of the fiscal years 1995

16 through 1998’’.