II 
110TH CONGRESS 
1ST SESSION H. R. 1132 
IN THE SENATE OF THE UNITED STATES 
MARCH 28, 2007 
Received 
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, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘National Breast and 
Cervical Cancer Early Detection Program Reauthorization 
Act of 2007’’. 
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 may waive the requirements of paragraphs 
(1) and (4) of subsection (a) for not more than 5 
States, if— 
‘‘(A) the State involved will use the waiver 
to leverage non-Federal funds to supplement 
each of the services or activities described in 
paragraphs (1) and (2) of section 1501(a); 
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‘‘(B) the application of such requirement 
would result in a barrier to the enrollment of 
qualifying women; 
‘‘(C) the State involved— 
‘‘(i) demonstrates, to the satisfaction 
of the Secretary, the manner in which the 
State will use such waiver to expand the 
level of screening and follow-up services 
provided immediately prior to the date on 
which the waiver is granted; and 
‘‘(ii) provides assurances, satisfactory 
to the Secretary, that the State will, on an 
annual basis, demonstrate, through such 
documentation as the Secretary may re-
quire, that the State has used such waiver 
as described in clause (i); 
‘‘(D) the State involved submits to the 
Secretary— 
‘‘(i) assurances, satisfactory to the 
Secretary, that the State will maintain the 
average annual level of State fiscal year ex-
penditures for the services and activities 
described in paragraphs (1) and (2) of sec-
tion 1501(a) for the period for which the 
waiver is granted, and for the period for 
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which any extension of such wavier is 
granted, at a level that is not less than— 
‘‘(I) the level of the State fiscal 
year expenditures for such services 
and activities for the fiscal year pre-
ceding the first fiscal year for which 
the waiver is granted; or 
‘‘(II) at the option of the State 
and upon approval by the Secretary, 
the average level of the State expendi-
tures for such services and activities 
for the 3-fiscal year period preceding 
the first fiscal year for which the 
waiver is granted; and 
‘‘(ii) a plan, satisfactory to the Sec-
retary, for maintaining the level of activi-
ties carried out under the waiver after the 
expiration of the waiver and any extension 
of such waiver; 
‘‘(E) the Secretary finds that granting 
such a waiver to a State will increase the num-
ber 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 
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making available screening procedures for both 
breast and cervical cancers; and 
‘‘(F) 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 that is not less than 1 year but not 
more than 2 years; and 
‘‘(ii) upon request of a State, may ex-
tend a waiver for an additional period that 
is not less than 1 year but not more than 
2 years 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 waiver period described in sub-
paragraph (A)(i), review performance under the 
waiver and may extend the waiver for an addi-
tional period if the Secretary determines that— 
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‘‘(i) without an extension of the waiv-
er, there will be a barrier to the enrollment 
of qualifying women; 
‘‘(ii) the State requesting such ex-
tended waiver will use the waiver to lever-
age non-Federal funds to supplement the 
services or activities described in para-
graphs (1) and (2) of section 1501(a); 
‘‘(iii) the waiver has increased, and 
will continue to increase, the number of 
women in the State that receive the serv-
ices or activities described in paragraphs 
(1) and (2) of section 1501(a); 
‘‘(iv) 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 
‘‘(v) 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 period for which the 
waiver was granted at a level that is not 
less than— 
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‘‘(I) the level of the State fiscal 
year expenditures for such services 
and activities for the fiscal year pre-
ceding the first fiscal year for which 
the waiver is granted; or 
‘‘(II) at the option of the State 
and upon approval by the Secretary, 
the average level of the State expendi-
tures for such services and activities 
for the 3-fiscal year period preceding 
the first fiscal year for which the 
waiver is granted. 
‘‘(3) REPORTING
REQUIREMENTS.—The Sec-
retary shall include as part of the evaluations and 
reports required under section 1508, the following: 
‘‘(A) A description of the total amount of 
dollars leveraged annually from Non-Federal 
entities in States receiving a waiver under para-
graph (1) and how these amounts were used. 
‘‘(B) With respect to States receiving a 
waiver under paragraph (1), a description of 
the percentage of the grant that is expended on 
providing each of the services or activities de-
scribed in— 
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‘‘(i) paragraphs (1) and (2) of section 
1501(a); and 
‘‘(ii) paragraphs (3) through (6) of 
section 1501(a). 
‘‘(C) A description of the number of States 
receiving waivers under paragraph (1) annually. 
‘‘(D) With respect to States receiving a 
waiver under paragraph (1), a description of— 
‘‘(i) the number of women receiving 
services under paragraphs (1), (2), and (3) 
of section 1501(a) in programs before and 
after the granting of such waiver; and 
‘‘(ii) the average annual level of State 
fiscal expenditures for the services and ac-
tivities described in paragraphs (1) and (2) 
of section 1501(a) for the year preceding 
the first year for which the waiver was 
granted. 
‘‘(4) LIMITATION.—Amounts to which a waiver 
applies under this subsection shall not be used to in-
crease the number of salaried employees. 
‘‘(5) DEFINITIONS.—In this subsection: 
‘‘(A) INDIAN
TRIBE.—The term ‘Indian 
tribe’ has the meaning given the term in section 
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4 of the Indian Health Care Improvement Act 
(25 U.S.C. 1603). 
‘‘(B) TRIBAL
ORGANIZATION.—The term 
‘tribal organization’ has the meaning given the 
term in section 4 of the Indian Health Care Im-
provement Act. 
‘‘(C) STATE.—The term ‘State’ means 
each of the several States of the United States, 
the District of Columbia, the Commonwealth of 
Puerto Rico, American Samoa, the Common-
wealth of the Northern Mariana Islands, the 
Republic of the Marshall Islands, the Federated 
States of Micronesia, the Republic of Palau, an 
Indian tribe, and a tribal organization. 
‘‘(6) SUNSET.—The Secretary may not grant a 
waiver or extension under this subsection after Sep-
tember 30, 2012.’’; 
(3) in section 1508— 
(A) in subsection (a), by striking ‘‘evalua-
tions of the extent to which’’ and all that fol-
lows through the period and inserting: ‘‘evalua-
tions of— 
‘‘(1) the extent to which States carrying out 
such programs are in compliance with section 
1501(a)(2) and with section 1504(c); and 
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‘‘(2) the extent to which each State receiving a 
grant under this title is in compliance with section 
1502, including identification of— 
‘‘(A) the amount of the non-Federal con-
tributions by the State for the preceding fiscal 
year, disaggregated according to the source of 
the contributions; and 
‘‘(B) the proportion of such amount of 
non-Federal 
contributions 
relative 
to 
the 
amount of Federal funds provided through the 
grant to the State for the preceding fiscal 
year.’’; and 
(B) in subsection (b), by striking ‘‘not 
later than 1 year after the date on which 
amounts are first appropriated pursuant to sec-
tion 1509(a), and annually thereafter’’ and in-
serting ‘‘not later than 1 year after the date of 
the enactment of the National Breast and Cer-
vical Cancer Early Detection Program Reau-
thorization of 2007, and annually thereafter’’; 
and 
(4) in section 1510(a)— 
(A) by striking ‘‘and’’ after ‘‘$150,000,000 
for fiscal year 1994,’’; and 
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(B) by inserting ‘‘, $225,000,000 for fiscal 
year 2008, $245,000,000 for fiscal year 2009, 
$250,000,000 
for 
fiscal 
year 
2010, 
$255,000,000 
for 
fiscal 
year 
2011, 
and 
$275,000,000 for fiscal year 2012’’ before the 
period at the end. 
Passed the House of Representatives March 27, 
2007. 
Attest: 
LORRAINE C. MILLER, 
Clerk. 
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