H. R. 1132
One Hundred Tenth Congress
of the
United States of America 
AT THE FIRST SESSION 
Begun and held at the City of Washington on Thursday, 
the fourth day of January, two thousand and seven 
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 Representatives 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 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 inserting ‘‘by 
the year 2020’’; 
(2) in section 1503, by adding at the end the following: 
‘‘(d) WAIVER
OF
SERVICES
REQUIREMENT
ON
DIVISION
OF 
FUNDS.—
‘‘(1) IN GENERAL.—The Secretary shall establish a dem-
onstration project under which the Secretary 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); 
‘‘(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 Sec-
retary, 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 Sec-
retary, that the State will, on an annual basis, dem-
onstrate, through such documentation as the Secretary 
may require, that the State has used such waiver 
as described in clause (i); 
‘‘(D) the State involved submits to the Secretary—
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‘‘(i) assurances, satisfactory to the Secretary, that 
the State will maintain the average annual level of 
State fiscal year expenditures for the services and 
activities described in paragraphs (1) and (2) of section 
1501(a) for the period for which the waiver is granted, 
and for the period for which any extension of such 
wavier is granted, at a level that is not less than—
‘‘(I) the level of the State fiscal year expendi-
tures for such services and activities for the fiscal 
year preceding 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 expenditures for such services and activi-
ties for the 3-fiscal year period preceding the first 
fiscal year for which the waiver is granted; and 
‘‘(ii) a plan, satisfactory to the Secretary, for 
maintaining the level of activities 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 number of women in the State 
that receive each of the services or activities described 
in paragraphs (1) and (2) of section 1501(a), including 
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 affect the quality of each 
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 para-
graph (1), the Secretary—
‘‘(i) shall grant such waivers for a period that 
is not less than 1 year but not more than 2 years; 
and 
‘‘(ii) upon request of a State, may extend a waiver 
for an additional period that is not less than 1 year 
but not more than 2 years in accordance with subpara-
graph (B). 
‘‘(B) ADDITIONAL
PERIOD.—The Secretary, upon the 
request of a State that has received a waiver under para-
graph (1), shall, at the end of the waiver period described 
in subparagraph (A)(i), review performance under the 
waiver and may extend the waiver for an additional period 
if the Secretary determines that—
‘‘(i) without an extension of the waiver, there will 
be a barrier to the enrollment of qualifying women; 
‘‘(ii) the State requesting such extended waiver 
will use the waiver to leverage 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 services or activities described in para-
graphs (1) and (2) of section 1501(a);
H. R. 1132—3
‘‘(iv) the waiver has not, and will not, result in 
lower quality in the State of the services or activities 
described in paragraphs (1) and (2) of section 1501(a); 
and 
‘‘(v) the State has maintained the average annual 
level of State fiscal expenditures for the services and 
activities described in paragraphs (1) and (2) of section 
1501(a) for the period for which the waiver was granted 
at a level that is not less than—
‘‘(I) the level of the State fiscal year expendi-
tures for such services and activities for the fiscal 
year preceding 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 expenditures for such services and activi-
ties for the 3-fiscal year period preceding the first 
fiscal year for which the waiver is granted. 
‘‘(3) REPORTING
REQUIREMENTS.—The Secretary shall 
include as part of the evaluations and reports required under 
section 1508, the following: 
‘‘(A) A description of the total amount of dollars lever-
aged annually from Non-Federal entities in States receiving 
a waiver under paragraph (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 activi-
ties described in—
‘‘(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 pro-
grams before and after the granting of such waiver; 
and 
‘‘(ii) the average annual level of State fiscal 
expenditures for the services and activities 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 increase 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 4 of the Indian Health 
Care Improvement Act (25 U.S.C. 1603). 
‘‘(B) TRIBAL ORGANIZATION.—The term ‘tribal organiza-
tion’ has the meaning given the term in section 4 of the 
Indian Health Care Improvement 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
H. R. 1132—4
Commonwealth 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 September 30, 2012.’’; 
(3) in section 1508—
(A) in subsection (a), by striking ‘‘evaluations of the 
extent to which’’ and all that follows through the period 
and inserting: ‘‘evaluations 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 
‘‘(2) the extent to which each State receiving a grant under 
this title is in compliance with section 1502, including identi-
fication of—
‘‘(A) the amount of the non-Federal contributions 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 con-
tributions 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 section 1509(a), and annually thereafter’’ and 
inserting ‘‘not later than 1 year after the date of the enact-
ment of the National Breast and Cervical Cancer Early 
Detection Program Reauthorization of 2007, and annually 
thereafter’’; and 
(4) in section 1510(a)—
(A) by striking ‘‘and’’ after ‘‘$150,000,000 for fiscal year 
1994,’’; and 
(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.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.