[House Report 111-635]
[From the U.S. Government Publishing Office]
111th Congress Report
2d Session HOUSE OF REPRESENTATIVES 111-635
=======================================================================
TO REAUTHORIZE AND ENHANCE JOHANNA'S LAW TO INCREASE PUBLIC AWARENESS
AND KNOWLEDGE WITH RESPECT TO GYNECOLOGIC CANCERS
_______
September 28, 2010.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Waxman, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 2941]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 2941) to reauthorize and enhance Johanna's Law
to increase public awareness and knowledge with respect to
gynecologic cancers, having considered the same, report
favorably thereon with an amendment and recommend that the bill
as amended do pass.
CONTENTS
Page
Amendment........................................................ 2
Purpose and Summary.............................................. 3
Background and Need for Legislation.............................. 3
Committee Consideration.......................................... 3
Committee Votes.................................................. 4
Committee Oversight Findings and Recommendations................. 4
New Budget Authority, Entitlement Authority, and Tax Expenditures 4
Statement of General Performance Goals and Objectives............ 4
Constitutional Authority Statement............................... 4
Earmarks and Tax and Tariff Benefit.............................. 4
Federal Advisory Committee Statement............................. 4
Applicability of Law to the Legislative Branch................... 4
Federal Mandates Statement....................................... 5
Committee Cost Estimate.......................................... 5
Congressional Budget Office Cost Estimate........................ 5
Section-by-Section Analysis of the Legislation................... 6
Explanation of Amendment......................................... 7
Changes in Existing Law Made by the Bill, as Reported............ 7
Amendment
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. REAUTHORIZATION AND ENHANCEMENT OF JOHANNA'S LAW.
(a) In General.--Section 317P(d) of the Public Health Service Act (42
U.S.C. 247b-17(d)(4)) is amended--
(1) in paragraph (4), by inserting after ``2009'' the
following: ``and $18,000,000 for the period of fiscal years
2012 through 2014''; and
(2) by redesignating paragraph (4) as paragraph (6).
(b) Consultation With Nonprofit Gynecologic Cancer Organizations.--
Section 317P(d) of such Act (42 U.S.C. 247b-17(d)), as amended by
subsection (a), is further amended by inserting after paragraph (3) the
following:
``(4) Consultation with nonprofit gynecologic cancer
organizations.--In carrying out the national campaign under
this subsection, the Secretary shall consult with the leading
nonprofit gynecologic cancer organizations, with a mission both
to conquer ovarian or other gynecologic cancer nationwide and
to provide outreach to State and local governments and
communities, for the purpose of determining the best practices
for providing gynecologic cancer information and outreach
services to varied populations.''.
SEC. 2. DEMONSTRATION PROJECTS REGARDING OUTREACH AND EDUCATION
STRATEGIES RELATING TO GYNECOLOGIC CANCER.
(a) In General.--Section 317P(d) of the Public Health Service Act (42
U.S.C. 247b-17(d)), as amended by section 1, is further amended by
inserting after paragraph (4) the following:
``(5) Demonstration projects regarding outreach and education
strategies.--
``(A) In general.--The Secretary may carry out a
program to award grants or contracts to public or
nonprofit private entities for the purpose of carrying
out demonstration projects to test and compare
different evidence-based outreach and education
strategies to increase the awareness and knowledge of
women and health care providers with respect to
gynecologic cancers, including early warning signs,
risk factors, prevention, screening, and treatment
options. Such strategies shall include efforts directed
at women and their families, physicians, nurses, and
key health professionals.
``(B) Preferences in awarding grants or contracts.--
In making awards under subparagraph (A), the Secretary
shall give preference to--
``(i) applicants with demonstrated expertise
in gynecologic cancer education or treatment or
in working with groups of women who are at
increased risk of gynecologic cancers; and
``(ii) applicants that, in the demonstration
project funded by the grant or contract, will
establish linkages between physicians, nurses,
and key health professionals, health profession
students, hospitals, payers, and State health
departments.
``(C) Application.--To seek a grant or contract under
subparagraph (A), an entity shall submit an application
to the Secretary in such form, in such manner, and
containing such agreements, assurances, and information
as the Secretary determines to be necessary to carry
out this paragraph.
``(D) Certain requirements.--In making awards under
subparagraph (A), the Secretary shall--
``(i) make awards, as practicable, to not
fewer than five applicants; and
``(ii) ensure that information provided
through demonstration projects under this
paragraph is consistent with the best available
medical information.
``(E) Report to congress.--Not later than 12 months
after the date of the enactment of this paragraph, and
annually thereafter, the Secretary shall submit to the
Congress a report that--
``(i) summarizes the activities of
demonstration projects under subparagraph (A);
``(ii) evaluates the extent to which the
projects were effective in increasing early
detection of gynecologic cancers and awareness
and knowledge of risk factors and early warning
signs in the populations to which the projects
were directed; and
``(iii) identifies barriers to early
detection and appropriate treatment of such
cancers.''.
(b) Conforming Amendment.--Section 317P(d)(3)(A) of the Public Health
Service Act (42 U.S.C. 247b-17(d)(3)(A)) is amended by inserting
``(other than paragraph (5))'' after ``this section''.
Purpose and Summary
H.R. 2941, a bill to reauthorize Johanna's Law, was
introduced on June 18, 2009, by Rep. Rosa DeLauro (D-CT), and
referred to the Committee on Energy and Commerce.
The goal of H.R. 2941 is to reauthorize and enhance
Johanna's Law to increase public awareness and knowledge with
respect to gynecologic cancers.
Background and Need for Legislation
Gynecologic cancers--cervical, ovarian, uterine, vaginal,
vulvar, and of the fallopian tube--are diagnosed in 77,000
women and kill approximately 28,000 women in the United States
every year.\1\ In December 2006, Congress passed the
Gynecologic Cancer Education Act of 2005, or Johanna's Law, to
direct the Department of Health and Human Services (HHS) to
develop a national awareness campaign about the signs,
symptoms, and risks of these cancers to educate women and
healthcare providers.\2\ This effort is administered through
the Centers for Disease Control and Prevention (CDC).
---------------------------------------------------------------------------
\1\CDC, Basic Information About Gynecologic Cancers (online at
http:www.cdc.gov/cancer/gynecologic/basic_info/).
\2\H.R. 1245, 109th Cong. (2005).
---------------------------------------------------------------------------
Since first receiving funds for these activities in fiscal
year 2008, CDC has developed a campaign called Inside
Knowledge: Get the Facts About Gynecologic Cancer, which
includes a Web site and factsheets, supported by focus group
research to assess the effectiveness of the efforts.\3\
Additional development and dissemination of materials is
ongoing.\4\
---------------------------------------------------------------------------
\3\CDC, Report to Congress Related to H.R. 1245, The Gynecologic
Cancer Education and Awareness Act of 2005, or Johanna's Law (Sept.
2008).
\4\Committee staff email communication with CDC (July 16, 2010).
---------------------------------------------------------------------------
Committee Consideration
H.R. 2941, a bill to reauthorize and enhance Johanna's Law
to increase public awareness and knowledge with respect to
gynecologic cancers, was introduced by Ms. DeLauro of
Connecticut on June 18, 2009, and referred to the Committee on
Energy and Commerce. The bill was subsequently referred to the
Subcommittee on Health on June 19, 2009. On September 15, 2010,
the Subcommittee held a legislative hearing on the bill. The
Subcommittee met in open markup session to consider H.R. 2941
on September 16, 2010. During Subcommittee consideration an
amendment in the nature of a substitute (manager's amendment)
by Mr. Pallone was adopted by a voice vote. Subsequently, H.R.
2941 was favorably forwarded to the full Committee, amended, by
a voice vote.
On September 23, 2010, the Committee on Energy and Commerce
met in open markup session and considered H.R. 2941 as approved
by the Subcommittee. There were no amendments offered in full
Committee and subsequently the Committee ordered H.R. 2941
favorably reported to the House, as amended by the Subcommittee
on Health, by a voice vote.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list each record vote
on the motion to report legislation and amendments thereto. A
motion by Mr. Waxman ordering H.R. 2941 reported to the House,
as amended, was approved by a voice vote. There were no record
votes taken during consideration of this bill.
Committee Oversight Findings and Recommendations
In compliance with clause 3(c)(1) of rule XIII and clause
2(b)(1) of rule X of the Rules of the House of Representatives,
the oversight findings and recommendations of the Committee are
reflected in the descriptive portions of this report, including
the finding that gynecological cancers kill tens of thousands
of women in the United States each year.
New Budget Authority, Entitlement Authority, and Tax Expenditures
Regarding compliance with clause 3(c)(2) of rule XIII of
the Rules of the House of Representatives, the Committee finds
that H.R. 2941 would result in no new budget authority,
entitlement authority, or tax expenditures or revenues.
Statement of General Performance Goals and Objectives
In accordance with clause 3(c)(4) of rule XIII of the Rules
of the House of Representatives, the performance goals and
objectives of the Committee are reflected in the descriptive
portions of this report, including the goal of increasing
public awareness and knowledge with respect to gynecologic
cancers.
Constitutional Authority Statement
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
constitutional authority for H.R. 2941 is provided under
article I, section 8, clauses 3 and 18 of the Constitution of
the United States.
Earmarks and Tax and Tariff Benefits
H.R. 2941 does not contain any congressional earmarks,
limited tax benefits, or limited tariff benefits as defined in
clause 9 of rule XXI of the Rules of the House of
Representatives.
Federal Advisory Committee Statement
The Committee finds that the legislation does not establish
or authorize the establishment of an advisory committee within
the definition of 5 U.S.C. App., section 5(b) of the Federal
Advisory Committee Act.
Applicability of Law to the Legislative Branch
Section 102(b)(3) of Public Law 104-1 requires a
description of the application of this bill to the legislative
branch where the bill relates to terms and conditions of
employment or access to public services and accommodations.
H.R. 2941 contains no such provisions.
Federal Mandates Statement
Section 423 of the Congressional Budget and Impoundment
Control Act of 1974 (as amended by section 101(a)(2) of the
Unfunded Mandates Reform Act, Public Law 104-4) requires a
statement on whether the provisions of the report include
unfunded mandates. In compliance with this requirement the
Committee adopts as its own the analysis of federal mandates
prepared by the Director of the Congressional Budget Office
regarding H.R. 2941.
Committee Cost Estimate
Pursuant to clause 3(d)(2) of rule XIII of the Rules of the
House of Representatives, the Committee adopts as its own the
cost estimate of H.R. 2941 prepared by the Director of the
Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
Congressional Budget Office Cost Estimate
With respect to the requirements of clause (3)(c)(3) of
rule XIII of the Rules of the House of Representatives and
section 402 of the Congressional Budget Act of 1974, the
Committee has received the following cost estimate for H.R.
2941 from the Director of Congressional Budget Office:
September 24, 2010.
Hon. Henry A. Waxman,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 2941, a bill to
reauthorize and enhance Johanna's Law to increase public
awareness and knowledge with respect to gynecologic cancers.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Lori Housman.
Sincerely,
Douglas W. Elmendorf.
Enclosure.
H.R. 2941--A bill to reauthorize and enhance Johanna's Law to increase
public awareness and knowledge with respect to gynecologic
cancers
Summary: H.R. 2941 would reauthorize Johanna's Law, which
directs the Secretary of Health and Human Services to conduct a
campaign to increase the awareness and knowledge of health care
providers and women with respect to gynecologic cancers. The
bill also would authorize additional activities including
outreach to state and local governments to determine best
practices for providing information and services, and awarding
grants to entities to test and compare outreach and education
strategies.
The bill would authorize the appropriation of $18 million
for fiscal years 2012 through 2014. Based on historical
spending patterns for similar activities, and assuming the
appropriation of the authorized amounts, CBO estimates that
implementing H.R. 2941 would cost $17 million over the 2011-
2015 period. Enacting this legislation would not affect direct
spending or revenues; therefore, pay-as-you-go procedures do
not apply.
H.R. 2941 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
Estimated cost to the Federal Government: The estimated
budgetary impact of H.R. 2941 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-----------------------------------------------------------
2011-
2011 2012 2013 2014 2015 2015
----------------------------------------------------------------------------------------------------------------
CHANGES IN SPENDING SUBJECT TO APPROPRIATIONEstimated Authorization Level....................... 0 6 6 6 0 18
Estimated Outlays................................... 0 2 5 6 4 17
----------------------------------------------------------------------------------------------------------------
Basis of estimate: H.R. 2941 would direct the Centers for
Disease Control and Prevention (CDC) to award grants to
eligible entities to conduct demonstration projects to test and
compare different outreach and education strategies to increase
the awareness and knowledge of women and health care providers
with respect to gynecologic cancers.
The bill would authorize the appropriation of $18 million
for fiscal years 2012 through 2014. For this estimate, CBO
assumes that one-third of the authorized amount ($6 million)
would be appropriated in each of those three years. The
activities authorized in this act would be carried out by the
CDC. Based on historical spending patterns for similar
activities, CBO estimates that implementing H.R. 2941 would
cost $17 million over the 2012-2015 period.
Pay-as-you-go considerations: None.
Intergovernmental or private-sector impact: H.R. 2941
contains no intergovernmental or private-sector mandates as
defined in UMRA and would impose no costs on state, local, or
tribal governments.
Estimate prepared by: Federal Costs: Lori Housman; Impact
on State, Local, and Tribal Governments: Lisa Ramirez-Branum;
Impact on the Private Sector: Sarah Axeen.
Estimate approved by: Holly Harvey, Deputy Assistant
Director for Budget Analysis.
Section-by-Section Analysis of the Legislation
Section 1. Reauthorization and enhancement of Johanna's Law
Section 1 reauthorizes Johanna's Law at a total level of
$18 million for the period of FY2012 through FY2014. It also
requires the Secretary of HHS to consult with nonprofit
gynecologic cancer organizations in determining best practices
for a national public awareness campaign.
Section 2. Demonstration projects regarding outreach and education
strategies relating to gynecologic cancer
Section 2 permits the Secretary of HHS to make grants for
demonstration projects to test outreach and education
strategies to inform women and healthcare providers about
gynecologic cancers, and to report to Congress on the
effectiveness of the projects.
Explanation of Amendment
During the Subcommittee on Health markup, Mr. Pallone of
New Jersey offered an amendment in the nature of a substitute
(manager's amendment), which was adopted by a voice vote. The
substance of the substitute amendment is reflected in the
section-by-section analysis contained in this report.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
Part B--Federal-State Cooperation
* * * * * * *
HUMAN PAPILLOMAVIRUS (JOHANNA'S LAW)
Sec. 317P. (a) * * *
* * * * * * *
(d) Johanna's Law.--
(1) * * *
* * * * * * *
(3) Full compliance.--
(A) In general.--Not later than March 1,
2008, the Secretary shall ensure that all
provisions of this section (other than
paragraph (5)), including activities directed
to be carried out by the Centers for Disease
Control and Prevention and the Food and Drug
Administration, are fully implemented and being
complied with. Not later than April 30, 2008,
the Secretary shall submit to Congress a report
that certifies compliance with the preceding
sentence and that contains a description of all
activities undertaken to achieve such
compliance.
* * * * * * *
(4) Consultation with nonprofit gynecologic cancer
organizations.--In carrying out the national campaign
under this subsection, the Secretary shall consult with
the leading nonprofit gynecologic cancer organizations,
with a mission both to conquer ovarian or other
gynecologic cancer nationwide and to provide outreach
to State and local governments and communities, for the
purpose of determining the best practices for providing
gynecologic cancer information and outreach services to
varied populations.
(5) Demonstration projects regarding outreach and
education strategies.--
(A) In general.--The Secretary may carry out
a program to award grants or contracts to
public or nonprofit private entities for the
purpose of carrying out demonstration projects
to test and compare different evidence-based
outreach and education strategies to increase
the awareness and knowledge of women and health
care providers with respect to gynecologic
cancers, including early warning signs, risk
factors, prevention, screening, and treatment
options. Such strategies shall include efforts
directed at women and their families,
physicians, nurses, and key health
professionals.
(B) Preferences in awarding grants or
contracts.--In making awards under subparagraph
(A), the Secretary shall give preference to--
(i) applicants with demonstrated
expertise in gynecologic cancer
education or treatment or in working
with groups of women who are at
increased risk of gynecologic cancers;
and
(ii) applicants that, in the
demonstration project funded by the
grant or contract, will establish
linkages between physicians, nurses,
and key health professionals, health
profession students, hospitals, payers,
and State health departments.
(C) Application.--To seek a grant or contract
under subparagraph (A), an entity shall submit
an application to the Secretary in such form,
in such manner, and containing such agreements,
assurances, and information as the Secretary
determines to be necessary to carry out this
paragraph.
(D) Certain requirements.--In making awards
under subparagraph (A), the Secretary shall--
(i) make awards, as practicable, to
not fewer than five applicants; and
(ii) ensure that information provided
through demonstration projects under
this paragraph is consistent with the
best available medical information.
(E) Report to congress.--Not later than 12
months after the date of the enactment of this
paragraph, and annually thereafter, the
Secretary shall submit to the Congress a report
that--
(i) summarizes the activities of
demonstration projects under
subparagraph (A);
(ii) evaluates the extent to which
the projects were effective in
increasing early detection of
gynecologic cancers and awareness and
knowledge of risk factors and early
warning signs in the populations to
which the projects were directed; and
(iii) identifies barriers to early
detection and appropriate treatment of
such cancers.
[(4)](6) Authorization of appropriations.--For the
purpose of carrying out this subsection, there is
authorized to be appropriated $16,500,000 for the
period of fiscal years 2007 through 2009 and
$18,000,000 for the period of fiscal years 2012 through
2014.
* * * * * * *