An Act To Enact the Recommendations of the Task Force To Study Cervical Cancer Prevention, Detection and Education
Maine Legislature, Session 123, LD 0137
Committee Amendment CA_A_S158 (Senate)

COMMITTEE AMENDMENT "A " to S.P. 45, L.D. 137, Bill, "An Act To Enact 
the Recommendations of the Task Force To Study Cervical Cancer Prevention, Detection 
and Education" 
Amend the bill by striking out the title and substituting the following: 
'Resolve, Requiring the Maine Center for Disease Control and Prevention To 
Report on Activities To Implement the Recommendations of the Task Force 
To Study Cervical Cancer Prevention, Detection and Education' 
Amend the bill by striking out everything after the title and before the summary and 
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inserting the following: 
'Sec. 1. 
Human papillomavirus vaccination; MaineCare reporting. 
Resolved: That the Department of Health and Human Services, Office of MaineCare 
Services shall provide information regarding the rate of human papillomavirus 
vaccination among MaineCare members to the Department of Health and Human 
Services, Maine Center for Disease Control and Prevention for inclusion in the reports 
required under section 8; and be it further 
Sec. 2. 
Human papillomavirus vaccination as a priority for future 
funding. 
Resolved: 
That the Department of Health and Human Services shall 
establish as a priority for future budget requests the need to provide sufficient resources 
to provide the human papillomavirus vaccination to the population of low-income 
females in Maine that fall into the age cohort identified by the federal Centers for Disease 
Control and Prevention as needing vaccination against the human papillomavirus; and be 
it further 
Sec. 3. Maine Immunization Program to report on program funding and 
vaccination distribution. Resolved: That the Department of Health and Human 
Services, Maine Immunization Program shall report to the joint standing committee of the 
Legislature having jurisdiction over health and human services matters regarding the 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT 'i4 "to S.P. 45, L.D. 137 
status of program funding, the number of doses of the vaccination distributed and other 
relevant data available. The program shall submit an initial report to the committee no 
later than January 30,2008 and a 2nd report no later than January 30, 2010. Each report 
must include: 
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1. Program budget information for the current year and previous 2 years, including 
specific information regarding expenditures on the human papillomavirus vaccine; and 
2. Documentation of any funding shortage that exists between available funds and 
the expenditures required to vaccinate 80% of Maine girls with the human papiIlomavirus 
vaccine and 80% of Maine children with the other vaccines on the federal Centers for 
Disease Control and Prevention recommended childhood and adolescent immunization 
schedule; and be it further 
Sec. 4. Report on public education provided regarding cervical cancer. 
Resolved: That the Department of Health and Human Services, Maine Breast and 
Cervical Health Program, shall report on statewide public education efforts regarding 
cervical cancer prevention and early detection, including the importance of cervical 
cancer screening and the availability of the human papiIIomavirus vaccine. 
The program shall report its progress and results in implementing this section to the 
Department of Health and Human Services, Maine Center for Disease Control and 
Prevention for inclusion in the initial and final evaluation reports required under section 
8; and be it further 
Sec. 5. Maine Breast and Cervical Health Program screening initiatives. 
Resolved: That the Department of Health and Human Services, Maine Breast and 
Cervical Health Program, referred to in this section as "the program," shall implement the 
following initiatives to increase and improve cervical cancer screening: 
1. The program shall collaborate with the Family Planning Association of Maine, Inc. 
to develop ideas for outreach and coordination to increase cervical cancer screening 
among women who are ineligible for the program, particularly women under 35 years of 
age; 
2. The program shall expand its special screening days. The expansion may include 
adding more sites, adding more screening days at current sites or a combination of these 
strategies, based on the program's assessed need and demand for services; 
3. The program shall update its clinical guidelines for cervical cancer screening based 
on a review of the most recent clinical guidelines for cervical cancer screening published 
by the American Cancer Society, the American College of Obstetricians and 
Gynecologists and the United States Preventive Services Task Force. The program shall 
offer a professional education program on clinical guidelines for cervical cancer 
screening after it has completed the update; and 
4. The program shall coordinate a stakeholder group, including representatives of the 
Department of Health and Human Services, Maine Comprehensive Cancer Control 
Program, the State Employee Health Commission, the American Cancer Society and 
health insurance carriers operating in the State, to explore options for encouraging 
insured individuals to make and attend medical appointments for cancer screening, 
including, but not limited to, cervical cancer screening. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT ':tj "to S.P. 45, L.D. 137 
The program shall report its progress and results in implementing this section to the 
Department of Health and Human Services, Maine Center for Disease Control and 
Prevention for inclusion in the reports required under section 8; and be it further 
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Sec. 6. Cervical cancer incidence and prevention in racial and ethnic 
minority populations. 
Resolved: 
That the Department of Health and Human 
Services, Office of Minority Health shall, in collaboration with the Department of Health 
and Human Services, Maine Cancer Registry, the Department of Health and Human 
Services, Office of Multicultural Affairs and the Department of Health and Human 
Services, Maine Comprehensive Cancer Control Program, convene meetings with racial 
and ethnic minority groups to examine cervical cancer incidence in racial and ethnic 
minority populations in the State and develop recommendations to improve cervical 
cancer prevention and early detection in these populations. 
The Department of Health and Human Services, Office of Minority Health shall 
report its findings and recommendations to the Department of Health and Human 
Services, Maine Center for Disease Control and Prevention for inclusion in the initial 
report required under section 8; and be it further 
Sec. 7. Geographic variations in cervical cancer rates. Resolved: That the 
Department of Health and Human Services, Maine Cancer Registry shall, in collaboration 
with the Department of Health and Human Services, Maine Breast and Cervical Health 
Program, examine geographic variation in cervical cancer rates within the State, and in 
particular the higher rates of cervical cancer observed in Washington County and 
Somerset County, and shall explore reasons for the variation. The Department of Health 
and Human Services, Maine Cancer Registry and the Department of Health and Human 
Services, Maine Breast and Cervical Health Program shall consult with the American 
Cancer Society, community organizations and health care providers to develop 
recommendations for reducing the incidence of cervical cancer in Washington County 
and Somerset County. The Department of Health and Human Services, Maine Cancer 
Registry shall report its findings and recommendations to the Department of Health and 
Human Services, Maine Center for Disease Control and Prevention for inclusion in the 
initial report required under section 8; and be it further 
Sec. 8. Evaluation of cervical cancer prevention, detection and education 
initiatives. Resolved: That the Department of Health and Human Services, Maine 
Center for Disease Control and Prevention shall monitor and evaluate the State's progress 
in cervical cancer prevention, detection and education in response to the work of the 
Legislature's Task Force to Study Cervical Cancer Prevention, Detection and Education. 
The center shall submit 2 reports to the joint standing committee of the Legislature 
having jurisdiction over health and human services matters. The reports must address the 
progress, status and outcomes of each initiative required under this resolve. The initial 
report must be submitted no later than January 30, 2009, and the final report must be 
submitted no later than January 30, 2011. After review of the initial report, the joint 
standing committee of the Legislature having jurisdiction over health and human services 
matters may submit legislation regarding cervical cancer prevention, detection and 
education to the First Regular Session of the 124th Legislature. After review of the final 
report, the joint standing committee of the Legislature having jurisdiction over health and 
COMMITTEE AMENDMENT 
ROVS, 
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COMMITTEE AMENDMENT "A "to S.P. 45, L.D. 137 
human services matters may submit legislation regarding cervical cancer prevention, 
detection and education to the First Regular Session of the 1 25th Legislature.' 
SUMMARY 
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This amendment changes the bill to a resolve and changes the title. 
It removes sections of the bill that require coverage and funding for the human 
papiIlomavirus vaccine. 
It removes sections of the bill that prescribe methods for 
carrying out a public education campaign and related to school-based education and 
continuing medical education. It removes sections requiring the Department of Health 
and Human Services to explore costs and benefits of requesting a Medicaid waiver to 
provide cervical cancer screening and to expand the eligibility for screening under the 
Maine Breast and Cervical Health Program. It removes the section requiring the Maine 
Quality Forum to review and report on health care system initiatives affecting the 
delivery of cervical cancer screening services. 
It adds a requirement that the department make the need for sufficient resources to 
provide the human papillomavirus vaccination to the population of low-income females 
in Maine that need the vaccine a priority in future budget requests. 
It retains the provisions in the bill requiring the department to report on expenditures 
and distribution of the human papillomavirus vaccine, public education efforts regarding 
cervical cancer, recommendations for improving cervical cancer prevention and detection 
in racial and ethnic minority populations, recommendations for reducing incidence of 
cervical cancer in Washington County and Somerset County and progress on 
implementing the recommendations of the Task Force To Study Cervical Cancer 
Prevention, Detection and Education. It requires the department to engage in these 4 
initiatives to improve cervical cancer screening and to report on the progress of those 
initiatives. It requires the department to submit an initial report to the joint standing 
committee of the Legislature having jurisdiction over health and human services matters 
no later than January 30, 2009 and a 2nd report no later than January 30, 2011. It 
authorizes the joint standing committee of the Legislature having jurisdiction over health 
and human services matters to submit legislation to the 124th Legislature and 125th 
Legislature. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Revised: 05/24/07 ~ac 
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I 
LD137 
LR 914(02) 
An Act To Enact the Recommendations of the Task Force To Study Cervical Cancer Prevention, 
Detection and Education 
Fiscal Detail and Notes 
Fiscal Note for Bill as Amended by Committee Amendment "A " 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Additional costs incurred by the Department of Health and Humans Services in implementing this bill can be absorbed 
by the department utilizing existing budget resources. 
LR0914(02) - Fiscal Note - Page 1 of 1