IB 
Union Calendar No. 424 
109TH CONGRESS 
2D SESSION 
H. R. 5472 
[Report No. 109–705] 
To amend the Public Health Service Act to provide waivers relating to 
grants for preventive health measures with respect to breast and cervical 
cancers. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 24, 2006 
Mrs. MYRICK (for herself, Ms. BALDWIN, Mr. NORWOOD, Mr. MURPHY, Mrs. 
CAPPS, Ms. ESHOO, Mr. WAXMAN, and Mr. DINGELL) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
SEPTEMBER 29, 2006 
Additional sponsors: Mr. REYES, Mr. UPTON, Ms. SOLIS, Ms. WOOLSEY, Mrs. 
BLACKBURN, Mr. KILDEE, Mrs. CHRISTENSEN, Mr. LEACH, Ms. KIL-
PATRICK of Michigan, Mrs. JO ANN DAVIS of Virginia, Mr. DELAHUNT, 
Mr. VAN HOLLEN, Ms. JACKSON-LEE of Texas, Mrs. LOWEY, Ms. MAT-
SUI, Ms. GINNY BROWN-WAITE of Florida, Mr. MCDERMOTT, Mr. 
CAPUANO, Ms. DELAURO, Mr. CONYERS, Mr. HINCHEY, Mr. GRIJALVA, 
Ms. BERKLEY, Mr. MCINTYRE, Mr. PORTER, Mr. NEAL of Massachu-
setts, Ms. WASSERMAN SCHULTZ, Mr. FARR, Mr. BROWN of Ohio, Mr. 
TERRY, Mr. KENNEDY of Rhode Island, Mr. GENE GREEN of Texas, Mr. 
GARY G. MILLER of California, Mr. BURTON of Indiana, Mr. MCCOTTER, 
Ms. HARMAN, Mr. HIGGINS, Mr. MILLER of North Carolina, Mr. COSTA, 
Mr. DOGGETT, Mr. BUYER, Mr. MORAN of Virginia, Mr. ALLEN, Mr. 
SANDERS, Mr. HASTINGS of Florida, Mr. CLEAVER, Ms. HOOLEY, Mr. 
HONDA, Ms. MCCOLLUM of Minnesota, Mr. BERMAN, Ms. SCHAKOWSKY, 
Mr. HINOJOSA, Mr. NADLER, Mr. CARDIN, Mr. RANGEL, Mr. WALSH, 
Ms. SCHWARTZ of Pennsylvania, Mr. SCOTT of Georgia, Mr. KING of 
New York, Mr. KIRK, Mr. GONZALEZ, Mr. EMANUEL, Mr. STARK, Mrs. 
WILSON of New Mexico, Mr. FRANK of Massachusetts, Mr. ISSA, Mr. 
LARSON of Connecticut, Mr. FOLEY, Mrs. BIGGERT, Mr. LEVIN, Mr. 
SHAYS, Mr. GILLMOR, Mr. UDALL of New Mexico, Mr. LIPINSKI, Mr. 
CUMMINGS, Mr. HALL, Ms. LINDA T. SA´NCHEZ of California, Mr. HOB-
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SON, Mr. OLVER, Mr. MOORE of Kansas, Mr. MCGOVERN, Mr. SIMMONS, 
Ms. PRYCE of Ohio, Mr. RAMSTAD, Mr. BOSWELL, Mrs. DAVIS of Cali-
fornia, Mr. MEEHAN, Mrs. MALONEY, Mr. BOEHLERT, Mr. LATHAM, Mr. 
RYAN of Wisconsin, Mr. COSTELLO, Mr. FITZPATRICK of Pennsylvania, 
Ms. MOORE
of Wisconsin, Ms. KAPTUR, Mrs. MCCARTHY, Ms. 
VELA´ZQUEZ, Ms. MILLENDER-MCDONALD, Mr. SCHIFF, Mr. LOBIONDO, 
Ms. HERSETH, Mr. WELDON of Pennsylvania, Mr. ORTIZ, Mr. MATHE-
SON, Mr. PETERSON of Minnesota, Ms. HARRIS, Mrs. CAPITO, Mr. PICK-
ERING, Mr. PALLONE, Mrs. NAPOLITANO, Mr. SAXTON, Mr. BURGESS, 
Mr. CAMP of Michigan, Mr. CALVERT, Ms. DEGETTE, Mr. WHITFIELD, 
Mr. BASS, and Mrs. BONO 
SEPTEMBER 29, 2006 
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 24, 2006] 
A BILL 
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 Representa-
tives 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 2006’’. 
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)— 
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(A) in the heading, by striking ‘‘2000’’ and 
inserting ‘‘2020’’; and 
(B) by striking ‘‘by the year 2000’’ and in-
serting ‘‘by the year 2020’’; 
(2) in section 1503, by adding at the end the fol-
lowing: 
‘‘(d) WAIVER OF SERVICES REQUIREMENT ON DIVI-
SION OF FUNDS.— 
‘‘(1) IN GENERAL.—The Secretary may waive 
the requirements of paragraphs (1) and (4) of sub-
section (a) if the Secretary finds that— 
‘‘(A)(i) the State involved will use the waiv-
er to leverage private funds to supplement each 
of the services or activities described in para-
graphs (1) and (2) of section 1501(a); or 
‘‘(ii) the application of such requirements 
would result in a barrier to the participation of 
qualifying women in the services or activities de-
scribed in paragraphs (1) and (2) of section 
1501(a); 
‘‘(B) granting such a waiver to the State 
will not reduce the number of women in the 
State who receive any of the services or activities 
described in paragraphs (1) and (2) of section 
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1501(a), including screening procedures for both 
breast and cervical cancers; and 
‘‘(C) granting such a waiver to the State 
will not adversely affect the quality of any 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 pe-
riod of 2 years; and 
‘‘(ii) upon request of a State, may ex-
tend a waiver for additional 2-year periods 
in accordance with subparagraph (B). 
‘‘(B) 
ADDITIONAL
PERIODS.—The 
Sec-
retary, upon the request of a State that has re-
ceived a waiver under paragraph (1), shall, at 
the end of each 2-year waiver period described in 
subparagraph (A), review performance under the 
waiver and may extend the waiver for an addi-
tional 2-year period if the Secretary finds that— 
‘‘(i)(I) the State involved will use the 
waiver to leverage private funds to supple-
ment each of the services or activities de-
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scribed in paragraphs (1) and (2) of section 
1501(a); or 
‘‘(II) without an extension of the waiv-
er, the application of the requirements of 
paragraphs (1) and (4) of subsection (a) 
would result in a barrier to the participa-
tion of qualifying women in the services or 
activities described in paragraphs (1) and 
(2) of section 1501(a); 
‘‘(ii) the waiver has not reduced, and 
granting the waiver extension will not re-
duce, the number of women in the State 
who receive any of the services or activities 
described in paragraphs (1) and (2) of sec-
tion 1501(a); and 
‘‘(iii) the waiver has not adversely af-
fected, and granting the waiver extension 
will not adversely affect, the quality in the 
State of any of the services or activities de-
scribed in paragraphs (1) and (2) of section 
1501(a). 
‘‘(3) REPORTING
REQUIREMENTS.—The Sec-
retary shall include as part of the evaluations and re-
ports required under section 1508, the following: 
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‘‘(A) A description of the total amount of 
dollars leveraged annually from private entities 
in States receiving a waiver under this sub-
section and how these amounts were used. 
‘‘(B) With respect to States receiving a 
waiver under this subsection, a description of— 
‘‘(i) the percentage of the grant that is 
expended on services or activities described 
in paragraphs (1) and (2) of section 
1501(a); and 
‘‘(ii) the percentage of the grant that is 
expended on services or activities described 
in paragraphs (3) through (6) of section 
1501(a). 
‘‘(C) A description of the number of States 
receiving waivers under this subsection annually. 
‘‘(D) With respect to States receiving a 
waiver under this subsection, a description of the 
number of women receiving services under para-
graphs (1), (2), and (3) of section 1501(a) in 
programs before and after the granting of such 
waiver.’’; 
(3) in section 1504(a), by striking ‘‘pursuant to 
paragraphs (1) and (2) of section 1501(a)’’ and in-
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