109TH CONGRESS 
2D SESSION 
H. R. 5472
AN ACT 
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)—
(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 
following: 
‘‘(d) WAIVER OF SERVICES REQUIREMENT ON DIVI-
SION OF FUNDS.—
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish a demonstration project under which the Sec-
retary, acting through the Director of the Centers 
for Disease Control and Prevention, may waive the 
requirements of paragraphs (1) and (4) of sub-
section (a) for not more than 5 States, if—
‘‘(A)(i) the State involved will use the 
waiver to leverage private funds to supplement
each of the services or activities described in 
paragraphs (1) and (2) of section 1501(a); or 
‘‘(ii) the application of such requirement 
would result in a barrier to the enrollment of 
qualifying women; 
‘‘(B) the State involved provides assur-
ances that the State will, on an annual basis, 
demonstrate to the Secretary the manner in 
which the State will use such waiver to main-
tain or expand the level of screening and follow-
up services provided immediately prior to the 
waiver, and provide documentation of compli-
ance with such maintenance or expansion re-
quirement; 
‘‘(C) the State involved submits to the Sec-
retary a plan for maintaining the level of activi-
ties carried out under the waiver after the expi-
ration of the waiver; 
‘‘(D) the Secretary finds that granting 
such a waiver to a State will not reduce the 
number of women in the State that receive each 
of the services or activities described in para-
graphs (1) and (2) of section 1501(a), including 
making available screening procedures for both 
breast and cervical cancers; and
‘‘(E) the Secretary finds that granting 
such a waiver to a State will not adversely af-
fect the quality of each of the services or activi-
ties described in paragraphs (1) and (2) of sec-
tion 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 an additional 2-year pe-
riod in accordance with subparagraph (B). 
‘‘(B) 
ADDITIONAL
PERIOD.—The 
Sec-
retary, upon the request of a State that has re-
ceived a waiver under paragraph (1), shall, at 
the end of the 2-year waiver period described in 
subparagraph (A), review performance under 
the waiver and may extend the waiver for an 
additional 2-year period if the Secretary deter-
mines that—
‘‘(i)(I) without an extension of the 
waiver, there will be a barrier to the enroll-
ment of qualifying women; or
‘‘(II) the State requesting such ex-
tended waiver will use the waiver to lever-
age private funds to supplement the serv-
ices or activities described in paragraphs 
(1) and (2) of section 1501(a); 
‘‘(ii) the waiver has not, and will not, 
reduce the number of women in the State 
that receive the services or activities de-
scribed in paragraphs (1) and (2) of sec-
tion 1501(a); 
‘‘(iii) the waiver has not, and will not, 
result in lower quality in the State of the 
services or activities described in para-
graphs (1) and (2) of section 1501(a); and 
‘‘(iv) the State has maintained the av-
erage annual level of State fiscal expendi-
tures for the services and activities de-
scribed in paragraphs (1) and (2) of sec-
tion 1501(a) for the 2 years for which the 
waiver was granted at a level that is not 
less than the level of the State fiscal ex-
penditures for such services and activities 
for the year preceding the first year for 
which the waiver is granted.