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 extend the program of grants relating to pre-
ventive health measures with respect to breast
and cervical cancer.
JUNE 10, 1993
Reported with an amendment, committed to the Commit-
tee of the Whole House on the State of the Union, and
ordered to be printed
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) intro-
duced 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 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 Public
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 inserting
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.
(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 in-
dividual or facility conducting such procedures pur-
suant to a grant to a State under section 1501 of such
Act) until there is in effect for the facility a certifi-
cate (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 ORGANIZA-
TIONS.—
‘‘(A) The Secretary, acting through the Di-
rector of the Centers for Disease Control and
Prevention, may make grants to tribes and tribal
organizations (as such terms are used in para-
graph (1)) for the purpose of carrying out pro-
grams described in section 1501(a). This title ap-
plies to such a grant (in relation to the jurisdic-
tion of the tribe or organization) to the same ex-
tent and in the same manner as such title ap-
plies 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 organization is
deemed to have been waived under paragraph
(2).’’.
(d) EVALUATIONS AND REPORTS.—Section 1508 of the
Public Health Service Act (42 U.S.C. 300n–4) is amend-
ed—
(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 following
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 ac-
tivities of the agencies of the Public Health Service (and
other appropriate Federal agencies) that are carried out to-
ward achieving the objectives established by the Secretary
for reductions in the incidence of breast and cervical cancer
in the United States by the year 2000. Such committee shall
be comprised of Federal officers or employees designated by
the heads of the agencies involved to serve on the committee
as representatives of the agencies, and such representatives
from other public or private entities as the Secretary deter-
mines to be appropriate.’’.
(f) TECHNICAL CORRECTIONS.—Title XV of the Public
Health Service Act (42 U.S.C. 300k et seq.) is amended—
(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 Serv-
ice 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 PRE-
VENTIVE 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 Con-
trol 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 practicable,
the provision of appropriate follow-up services; 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 in-
volved 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 PRO-
GRAM.—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 au-
thorized to be appropriated $3,000,000 for fiscal year
1994, and such sums as may be necessary for each of
the fiscal years 1995 through 1998.
‘‘(2) LIMITATION REGARDING FUNDING WITH RE-
SPECT TO BREAST AND CERVICAL CANCER.—The au-
thorization 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 appropriated
under such section for the preceding fiscal year.’’.
(b) CONFORMING AMENDMENT.—Section 1510(a) of
the Public Health Service Act, as redesignated by subsection
(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’’.