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 meas-
ures with respect to breast and cervical cancer.
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 ‘‘Breast and Cervical
Cancer Amendments of 1993’’.
SEC. 2. REVISIONS IN PROGRAM OF STATE GRANTS RE-
GARDING BREAST AND CERVICAL CANCER.
(a) LIMITED AUTHORITY REGARDING FOR-PROFIT
ENTITIES.—
(1) IN GENERAL.—Section 1501(b) of the Pub-
lic Health Service Act (42 U.S.C. 300k(b)) is
amended—
(A) by striking ‘‘STATES.—A State’’ and
all that follows through ‘‘may expend’’ and in-
serting the following: ‘‘STATES.—
‘‘(1) IN GENERAL.—A State receiving a grant
under subsection (a) may, subject to paragraphs (2)
and (3), expend’’; and
(B) by adding at the end the following
paragraphs:
‘‘(2) LIMITED AUTHORITY REGARDING OTHER
ENTITIES.—In addition to the authority established
in paragraph (1) for a State with respect to grants
and contracts, the State may provide for screenings
under subsection (a)(1) through entering into con-
tracts with private entities.
‘‘(3) 
PAYMENTS
FOR
SCREENINGS.—The
amount paid by a State to an entity under this sub-
section for a screening procedure under subsection
(a)(1) may not exceed the amount that would be
paid under part B of title XVIII of the Social Secu-
rity Act if payment were made under such part for
furnishing the procedure to a woman enrolled under
such part.’’.
(2) 
CONFORMING
AMENDMENT.—Section
1505(3) of the Public Health Service Act (42 U.S.C.
300n-1(3)) is amended by inserting before the semi-
colon the following: ‘‘(and additionally, in the case of
services and activities under section 1501(a)(1), with
any similar services or activities of private entities)’’.
(b) QUALITY ASSURANCE REGARDING SCREENING
PROCEDURES.—
(1) IN GENERAL.—Section 1503 of the Public
Health Service Act (42 U.S.C. 300m) is amended by
striking subsections (c) through (e) and inserting
the following:
‘‘(c) QUALITY ASSURANCE REGARDING SCREENING
PROCEDURES.—The Secretary may not make a grant
under section 1501 unless the State involved agrees that
the State will, in accordance with applicable law, assure
the quality of screening procedures conducted pursuant to
such section.’’.
(2) TRANSITION
RULE
REGARDING
MAMMO-
GRAPHIES.—With respect to the screening procedure
for breast cancer known as a mammography, the re-
quirements in effect on the day before the date of
the enactment of this Act under section 1503(c) of
the Public Health Service Act remain in effect (for
an individual or facility conducting such procedures
pursuant to a grant to a State under section 1501
of such Act) until there is in effect for the facility
a certificate (or provisional certificate) issued under
section 354 of such Act.
(c) STATEWIDE PROVISION OF SERVICES.—Section
1504(c) of the Public Health Service Act (42 U.S.C.
300n(c)) is amended by adding at the end the following
paragraph:
‘‘(3) GRANTS TO TRIBES AND TRIBAL ORGANI-
ZATIONS.—
‘‘(A) The Secretary, acting through the Di-
rector of the Centers for Disease Control and
Prevention, may make grants to tribes and trib-
al organizations (as such terms are used in
paragraph (1)) for the purpose of carrying out
programs described in section 1501(a). This
title applies to such a grant (in relation to the
jurisdiction of the tribe or organization) to the
same extent and in the same manner as such
title applies to a grant to a State under section
1501 (in relation to the jurisdiction of the
State).
‘‘(B) If a tribe or tribal organization is re-
ceiving a grant under subparagraph (A) and the
State in which the tribe or organization is lo-
cated is receiving a grant under section 1501,
the requirement established in paragraph (1)
for the State regarding the tribe or organiza-
tion is deemed to have been waived under para-
graph (2).’’.
(d) EVALUATIONS AND REPORTS.—Section 1508 of
the Public Health Service Act (42 U.S.C. 300n–4) is
amended—
(1) in subsection (a), by adding at the end the
following sentence: ‘‘Such evaluations shall include
evaluations of the extent to which States carrying
out such programs are in compliance with section
1501(a)(2) and with section 1504(c).’’; and
(2) in subsection (b), by inserting before the pe-
riod the following: ‘‘, including recommendations re-
garding compliance by the States with section
1501(a)(2) and with section 1504(c)’’.
(e) ESTABLISHMENT
OF COORDINATING COMMIT-
TEE.—Section 1501 of the Public Health Service Act (42
U.S.C. 300k) is amended by adding at the end the follow-
ing subsection:
‘‘(c) COORDINATING COMMITTEE REGARDING YEAR
2000 HEALTH
OBJECTIVES.—The Secretary, acting
through the Director of the Centers for Disease Control
and Prevention, shall establish a committee to coordinate
the activities of the agencies of the Public Health Service
(and other appropriate Federal agencies) that are carried
out toward achieving the objectives established by the Sec-
retary for reductions in the incidence of breast and cer-
vical cancer in the United States by the year 2000. Such
committee shall be comprised of Federal officers or em-
ployees designated by the heads of the agencies involved
to serve on the committee as representatives of the agen-
cies, and such representatives from other public or private
entities as the Secretary determines to be appropriate.’’.
(f) TECHNICAL CORRECTIONS.—Title XV of the Pub-
lic Health Service Act (42 U.S.C. 300k et seq.) is amend-
ed—
(1) in section 1501(a), in the matter preceding
paragraph (1), by striking ‘‘Control,’’ and inserting
‘‘Control and Prevention,’’; and
(2) in section 1505—
(A) 
in 
paragraph 
(3), 
by 
striking
‘‘nonprivate’’ and inserting ‘‘nonprofit private’’;
and
(B) in paragraph (4), by inserting ‘‘will’’
before ‘‘be used’’.
SEC. 3. ESTABLISHMENT OF DEMONSTRATION PROGRAM
OF GRANTS FOR ADDITIONAL PREVENTIVE
HEALTH SERVICES FOR WOMEN.
(a) IN GENERAL.—Title XV of the Public Health
Service Act (42 U.S.C. 300k et seq.) is amended—
(1) by redesignating section 1509 as section
1510; and
(2) by inserting after section 1508 the following
section:
‘‘SEC. 1509. SUPPLEMENTAL GRANTS FOR ADDITIONAL
PREVENTIVE HEALTH SERVICES.
‘‘(a) DEMONSTRATION PROJECTS.—In the case of
States receiving grants under section 1501, the Secretary,
acting through the Director of the Centers for Disease
Control and Prevention, may make grants to not more
than 3 such States to carry out demonstration projects
for the purpose of—
‘‘(1) providing preventive health services in ad-
dition to the services authorized in such section, in-
cluding screenings regarding blood pressure and cho-
lesterol, and including health education;
‘‘(2) providing appropriate referrals for medical
treatment of women receiving services pursuant to
paragraph (1) and ensuring, to the extent prac-
ticable, the provision of appropriate follow-up serv-
ices; and
‘‘(3) evaluating activities conducted under para-
graphs (1) and (2) through appropriate surveillance
or program-monitoring activities.
‘‘(b) STATUS AS PARTICIPANT IN PROGRAM REGARD-
ING BREAST
AND CERVICAL CANCER.—The Secretary
may not make a grant under subsection (a) unless the
State involved agrees that services under the grant will
be provided only through entities that are screening
women for breast or cervical cancer pursuant to a grant
under section 1501.
‘‘(c) APPLICABILITY OF PROVISIONS OF GENERAL
PROGRAM.—This title applies to a grant under subsection
(a) to the same extent and in the same manner as such
title applies to a grant under section 1501.
‘‘(d) FUNDING.—
‘‘(1) IN GENERAL.—Subject to paragraph (2),
for the purpose of carrying out this section, there
are authorized to be appropriated $3,000,000 for
fiscal year 1994, and such sums as may be nec-
essary for each of the fiscal years 1995 through
1998.
‘‘(2) LIMITATION
REGARDING
FUNDING
WITH
RESPECT TO BREAST AND CERVICAL CANCER.—The
authorization of appropriations established in para-
graph (1) is not effective for a fiscal year unless the
amount appropriated under section 1510(a) for the
fiscal year equals or exceeds the amount appro-
priated under such section for the preceding fiscal
year.’’.
(b) CONFORMING AMENDMENT.—Section 1510(a) of
the Public Health Service Act, as redesignated by sub-
section (a)(1) of this section, is amended in the heading
for the section by striking ‘‘FUNDING.’’ and inserting
‘‘FUNDING FOR GENERAL PROGRAM.’’.
SEC. 4. FUNDING FOR GENERAL PROGRAM.
Section 1510(a) of the Public Health Service Act, as
redesignated by section 3(a)(1) of this Act, is amended—
(1) by striking ‘‘and’’ after ‘‘1991,’’; and
(2) by inserting before the period the following:
‘‘, $135,000,000 for fiscal year 1994, and such sums
as may be necessary for each of the fiscal years
1995 through 1998’’.
Passed the House of Representatives June 14, 1993.
Attest:
DONNALD K. ANDERSON,
Clerk.