Calendar No. 91

103D CONGRESS

1ST SESSION H. R. 2202

AN ACT

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 15, 1993

Received; read twice and placed on the calendar
II

Calendar No. 91

103D CONGRESS

1ST SESSION H. R. 2202

IN THE SENATE OF THE UNITED STATES

JUNE 15, 1993

Received; read twice and placed on the calendar

AN ACT

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.

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.—
2

•HR 2202 PCS

1 (1) IN GENERAL.—Section 1501(b) of the Pub2 lic Health Service Act (42 U.S.C. 300k(b)) is

3 amended—

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

5 all that follows through ‘‘may expend’’ and in6 serting the following: ‘‘STATES.—

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

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

9 and (3), expend’’; and

10 (B) by adding at the end the following

11 paragraphs:

12 ‘‘(2) LIMITED AUTHORITY REGARDING OTHER

13 ENTITIES.—In addition to the authority established

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

15 and contracts, the State may provide for screenings

16 under subsection (a)(1) through entering into con17 tracts with private entities.

18 ‘‘(3) PAYMENTS FOR SCREENINGS.—The

19 amount paid by a State to an entity under this sub20 section for a screening procedure under subsection

21 (a)(1) may not exceed the amount that would be

22 paid under part B of title XVIII of the Social Secu23 rity Act if payment were made under such part for

24 furnishing the procedure to a woman enrolled under

25 such part.’’.
3

•HR 2202 PCS

1 (2) CONFORMING AMENDMENT.—Section

2 1505(3) of the Public Health Service Act (42 U.S.C.

3 300n-1(3)) is amended by inserting before the semi4 colon the following: ‘‘(and additionally, in the case of

5 services and activities under section 1501(a)(1), with

6 any similar services or activities of private entities)’’.

7 (b) QUALITY ASSURANCE REGARDING SCREENING

8 PROCEDURES.—

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

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

11 striking subsections (c) through (e) and inserting

12 the following:

13 ‘‘(c) QUALITY ASSURANCE REGARDING SCREENING

14 PROCEDURES.—The Secretary may not make a grant

15 under section 1501 unless the State involved agrees that

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

17 the quality of screening procedures conducted pursuant to

18 such section.’’.

19 (2) TRANSITION RULE REGARDING MAMMO20 GRAPHIES.—With respect to the screening procedure

21 for breast cancer known as a mammography, the re22 quirements in effect on the day before the date of

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

24 the Public Health Service Act remain in effect (for

25 an individual or facility conducting such procedures
4

•HR 2202 PCS

1 pursuant to a grant to a State under section 1501

2 of such Act) until there is in effect for the facility

3 a certificate (or provisional certificate) issued under

4 section 354 of such Act.

5 (c) STATEWIDE PROVISION OF SERVICES.—Section

6 1504(c) of the Public Health Service Act (42 U.S.C.

7 300n(c)) is amended by adding at the end the following

8 paragraph:

9 ‘‘(3) GRANTS TO TRIBES AND TRIBAL ORGANI10 ZATIONS.—

11 ‘‘(A) The Secretary, acting through the Di12 rector of the Centers for Disease Control and

13 Prevention, may make grants to tribes and trib14 al organizations (as such terms are used in

15 paragraph (1)) for the purpose of carrying out

16 programs described in section 1501(a). This

17 title applies to such a grant (in relation to the

18 jurisdiction of the tribe or organization) to the

19 same extent and in the same manner as such

20 title applies to a grant to a State under section

21 1501 (in relation to the jurisdiction of the

22 State).

23 ‘‘(B) If a tribe or tribal organization is re24 ceiving a grant under subparagraph (A) and the

25 State in which the tribe or organization is lo-
5

•HR 2202 PCS

1 cated is receiving a grant under section 1501,

2 the requirement established in paragraph (1)

3 for the State regarding the tribe or organiza4 tion is deemed to have been waived under para5 graph (2).’’.

6 (d) EVALUATIONS AND REPORTS.—Section 1508 of

7 the Public Health Service Act (42 U.S.C. 300n–4) is

8 amended—

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

10 following sentence: ‘‘Such evaluations shall include

11 evaluations of the extent to which States carrying

12 out such programs are in compliance with section

13 1501(a)(2) and with section 1504(c).’’; and

14 (2) in subsection (b), by inserting before the pe15 riod the following: ‘‘, including recommendations re16 garding compliance by the States with section

17 1501(a)(2) and with section 1504(c)’’.

18 (e) ESTABLISHMENT OF COORDINATING COMMIT19 TEE.—Section 1501 of the Public Health Service Act (42

20 U.S.C. 300k) is amended by adding at the end the follow21 ing subsection:

22 ‘‘(c) COORDINATING COMMITTEE REGARDING YEAR

23 2000 HEALTH OBJECTIVES.—The Secretary, acting

24 through the Director of the Centers for Disease Control

25 and Prevention, shall establish a committee to coordinate
6

•HR 2202 PCS

1 the activities of the agencies of the Public Health Service

2 (and other appropriate Federal agencies) that are carried

3 out toward achieving the objectives established by the Sec4 retary for reductions in the incidence of breast and cer5 vical cancer in the United States by the year 2000. Such

6 committee shall be comprised of Federal officers or em7 ployees designated by the heads of the agencies involved

8 to serve on the committee as representatives of the agen9 cies, and such representatives from other public or private

10 entities as the Secretary determines to be appropriate.’’.

11 (f) TECHNICAL CORRECTIONS.—Title XV of the Pub12 lic Health Service Act (42 U.S.C. 300k et seq.) is amend13 ed—

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

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

16 ‘‘Control and Prevention,’’; and

17 (2) in section 1505—

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

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

20 and

21 (B) in paragraph (4), by inserting ‘‘will’’

22 before ‘‘be used’’.
7

•HR 2202 PCS

1 SEC. 3. ESTABLISHMENT OF DEMONSTRATION PROGRAM

2 OF GRANTS FOR ADDITIONAL PREVENTIVE

3 HEALTH SERVICES FOR WOMEN.

4 (a) IN GENERAL.—Title XV of the Public Health

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

6 (1) by redesignating section 1509 as section

7 1510; and

8 (2) by inserting after section 1508 the following

9 section:

10 ‘‘SEC. 1509. SUPPLEMENTAL GRANTS FOR ADDITIONAL

11 PREVENTIVE HEALTH SERVICES.

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

13 States receiving grants under section 1501, the Secretary,

14 acting through the Director of the Centers for Disease

15 Control and Prevention, may make grants to not more

16 than 3 such States to carry out demonstration projects

17 for the purpose of—

18 ‘‘(1) providing preventive health services in ad19 dition to the services authorized in such section, in20 cluding screenings regarding blood pressure and cho21 lesterol, and including health education;

22 ‘‘(2) providing appropriate referrals for medical

23 treatment of women receiving services pursuant to

24 paragraph (1) and ensuring, to the extent prac25 ticable, the provision of appropriate follow-up serv26 ices; and
8

•HR 2202 PCS

1 ‘‘(3) evaluating activities conducted under para2 graphs (1) and (2) through appropriate surveillance

3 or program-monitoring activities.

4 ‘‘(b) STATUS AS PARTICIPANT IN PROGRAM REGARD5 ING BREAST AND CERVICAL CANCER.—The Secretary

6 may not make a grant under subsection (a) unless the

7 State involved agrees that services under the grant will

8 be provided only through entities that are screening

9 women for breast or cervical cancer pursuant to a grant

10 under section 1501.

11 ‘‘(c) APPLICABILITY OF PROVISIONS OF GENERAL

12 PROGRAM.—This title applies to a grant under subsection

13 (a) to the same extent and in the same manner as such

14 title applies to a grant under section 1501.

15 ‘‘(d) FUNDING.—

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

17 for the purpose of carrying out this section, there

18 are authorized to be appropriated $3,000,000 for

19 fiscal year 1994, and such sums as may be nec20 essary for each of the fiscal years 1995 through

21 1998.

22 ‘‘(2) LIMITATION REGARDING FUNDING WITH

23 RESPECT TO BREAST AND CERVICAL CANCER.—The

24 authorization of appropriations established in para25 graph (1) is not effective for a fiscal year unless the
9

•HR 2202 PCS

1 amount appropriated under section 1510(a) for the

2 fiscal year equals or exceeds the amount appro3 priated under such section for the preceding fiscal

4 year.’’.

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

6 the Public Health Service Act, as redesignated by sub7 section (a)(1) of this section, is amended in the heading

8 for the section by striking ‘‘FUNDING.’’ and inserting

9 ‘‘FUNDING FOR GENERAL PROGRAM.’’.

10 SEC. 4. FUNDING FOR GENERAL PROGRAM.

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

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

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

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

15 ‘‘, $135,000,000 for fiscal year 1994, and such sums

16 as may be necessary for each of the fiscal years

17 1995 through 1998’’.

Passed the House of Representatives June 14, 1993.

Attest: DONNALD K. ANDERSON,

Clerk.