,,ii  #aai? ,,congress  #b;d ,session   
,s4 #eedf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #bd1         
#bjbf,mrs4 ,murray 7= h]self1 ,mrs4     
,%ahe51 ,mrs4 ,gillibr&1 ,mr4 ,blum5?al1
 ,mr4 ,gallego1 ,mr4 ,book]1 ,mr4 ,van  
,holl51 ,ms4 ,baldw91 ,ms4 ,klobu*>1    
,ms4 ,ros51 ,mr4 ,wyd51 ,mr4 ,m]kley1   
,mr4 ,:iteh\se1 ,mr4 ,s*iff1 & ,ms4     
,duckwor?7 introduc$ ! foll[+ bill2 :i* 
0 read twice & ref]r$ to ! ,committee on
 ,heal?1 ,education1 ,labor1 & ,p5sions 
,a ,,bill  ,to provide wom5 ) increas$  
access to prev5tive & life-sav+ canc]   
scre5+4  #a4 ,%ort title ,?is ,act may  
be cit$ z ! ,jeanette ,aco/a ,inve/ 9   
,wom5's ,heal? ,act ( #bjbf4  #b4       
,purpose ,x is ! purpose ( ?is ,act to  
provide wom5 ) increas$ access to       
prev5tive & life-sav+ canc] scre5+      
7includ+ cl9ical brea/ exams & brea/1   
c]vical1 ov>ian1 ut]9e1 vag9al1 & vulv> 
canc] scre5+71 z well z access to       
appropriate c>e & e>ly detection        
7includ+ via diagno/ic te/+ & treatm5t &

 provid] education & aw>5ess ( be/      
cl9ical practices71 provid$ by lead+    
wom5's heal? c>e provid]s :o-- 7#a7 s]ve
 populations mo/ at risk ( lack+ access 
to prev5tive c>e2 &  7#b7 play an       
outsiz$ role 9 ! prev5tion & detection (
 canc] 9 ord] to s]ve ! goal ( increas+ 
access to quality heal? scre5+s1 c>e1 & 
s]vices1 r$uc+ heal? c>e disp>ities &   
mortality rates among l[-income wom5 &  
wom5 ( color1 decreas+ heal? c>e sp5d+1 
& exp&+ heal? lit]acy1 access1 &        
education ab\t ! b5efits ( regul>       
prev5tive canc] scre5+ = wom54  #c4     
,f9d+s ,congress f9ds z foll[s3 7#a7    
,brea/ canc] is ! mo/ common canc] 9    
wom5 9 ! ,unit$ ,/ates & is ! lead+     
cause ( canc] dea? 9 wom5 ag$ #bj to #di
 9 ! ,unit$ ,/ates4  7#b7 ,ov>ian canc] 
causes m dea?s ?an any o!r canc] ( !    
female reproductive sy/em1 b x acc\nts =
 only ab\t #a4a p]c5t ( all canc]s 9    
wom54  7#c7 ,!re w be an e/imat$        
#dci1egj new cases ( brea/ &            
gynecological canc]s 9 ! ,unit$ ,/ates 9

 #bjbf4  7#d7 ,rates ( incid5ce & dea? =
 gynecologic canc]s by race & e?nicity  
%[ t1 :ile = "s canc]s1 l ov>ian canc]1 
! rates ( incid5ce & dea? are simil>    
among all races1 = o!r canc]s1 l c]vical
 canc]1 wom5 ( color h disproportionate 
incid5ce & mortality rates4 ,:ile !     
incid5ce ( ut]9e canc] is simil> = ,:ite
 wom5 & wom5 ( color1 rates ( dea? =    
ut]9e canc] are #b times high] = ,black 
wom5 ?an = ,:ite wom54 ,native ,hawaiian
 & ,pacific ,isl&] wom5 exp]i5ce dea?   
rates up to #c4c times high] ?an ,:ite  
wom5 f c]vical1 /oma*1 & ut]9e canc]s4  
7#e7 ,brea/ canc] rates are ris+ fa/] 9 
,asian ,am]ican & ,pacific ,isl&] wom5  
?an 9 any o!r racial or e?nic gr\p 9 !  
,unit$ ,/ates4  7#f7 ,c]vical canc]     
incid5ce & mortality rates are high] =  
wom5 liv+ 9 rural & und]s]v$ regions 9 !
 ,unit$ ,/ates4 ,wom5 liv+ 9 su* areas  
face unique b>ri]s 9 access+            
reproductive heal? c>e s]vices to prev5t
 & treat c]vical canc]1 includ+ a lack (
 practic+ gynecologi/s 9 rural areas &  

*all5ges ar\nd transportation to        
prev5tive & foll[-up appo9tm5ts4  7#g7  
,prev5tion & canc] scre5+ are ! be/     
approa*es to protect+ wom5 f canc] &    
ensur+ e>ly detection & life-sav+       
treatm5t4 ,_m dea?s f brea/ & c]vical   
canc]s c\ld be avoid$ if canc] scre5+   
rates & diagno/ic c>e & s]vices increas$
 among wom5 at risk4 ,dea?s f su* canc]s
 occur disproportionately among wom5 :o 
are un9sur$ or und]9sur$4  7#h7 ,due to 
enhanc$ scre5+1 c]vical canc] is n[ a   
mu* m prev5table & treatable canc]4 ,x  
is also highly curable :5 f\nd & treat$ 
e>ly4  7#i7 ,increas$ access to         
education2 in=mation1 includ+ in=mation 
on ! human papillomavirus vacc9e2 &     
prev5tive canc] scre5+s1 result+ 9      
timely & adequate treatm5t1 increase    
wom5's ability to survive canc]4  7#aj7 
,:ile m ?an #bj p]c5t ( cases ( c]vical 
canc] are f\nd 9 wom5 ov] ! age ( #fe1 x
 becomes less likely t wom5 are te/$ =  
c]vical canc] ev] or )9 ! previ\s #e    
ye>s z _! age increases4  7#aa7 ,wom5's 

heal? c>e provid]s t are prim>ily engag$
 9 family plann+ s]vices1 su* z ,plann$ 
,p>5?ood heal? c5t]s1 provide necess>y  
scre5+ te/s1 education1 & in=mation to  
wom51 especially wom5 ( color :o face ! 
highe/ risks ( brea/ canc] & o!r        
gynecologic canc]s4  7#ab7 ,access to   
prev5tive gynecological scre5+ is also  
critical = transg5d] m5 :o h comp>able  
rates ( susceptibility to c]vical canc] 
z cisg5d] wom51 b (t5 h less access to  
prev5tive scre5+s4  7#ac7 ,discrim9ation
 & racism 9 heal? c>e cont9ues to       
contribute to disp>ate rates (          
gynecological canc] 9 non-,:ite wom54   
,black1 ,indig5\s1 & o!r wom5 ( color   
die at high] rates f c]vical canc] ?an  
,:ite wom51 ev5 ?\gh few] wom5 ov]all   
die f c]vical canc]4  7#ad7 ,black wom5 
) endometrial canc] (t5 receive surg]y  
less (t5 ?an ,:ite wom5 & are m likely  
to be diagnos$ at an advanc$ /age ( !   
disease1 contribut+ to disp>ities 9     
mortality 9 ,black wom54  #d4 ,/r5g!n+  
access to canc] scre5+ = wom5 ,"p ,b (  

title ,,iii ( ! ,public ,heal? ,s]vice  
,act 7#db ,u4,s4,c4 #bdc et seq47 is    
am5d$ by ins]t+ aft] section #cag,p !   
foll[+3  #cag,p-#a4 ,grants = wom5's    
heal? c>e provid]s  7a7 ,9 g5]al ,!     
,secret>y is au?oriz$ to make grants &  
to ent] into contracts ) public or      
nonpr(it private entities to exp&       
prev5tive heal? s]vices1 includ+ ! canc]
 scre5+ s]vices requir$ to be cov]$ by  
gr\p heal? plans & heal? insurance      
cov]age pursuant to section             
#bgac7;a77#d74 ,9 aw>d+ su* grants1 !   
,secret>y %all seek to increase access  
to critical1 life-sav+ canc] scre5+1    
c]vical cytology 7commonly ref]r$ to z  
,pap te/s71 human papillomavirus te/s1  
human papillomavirus & ,pap cote/s1     
self-collection = human papillomavirus  
te/+1 human papillomavirus vacc9ations1 
& diagno/ic te/s = wom5 ) canc]         
symptoms1 p>ticul>ly wom5 ( color4  7b7 
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ to c>ry out  
?is section1 #bj1jjj1jjj = ea* ( fiscal 

ye>s #bjbg ?r\gh #bjbi4  4  #e4 ,exp&+  
canc] scre5+ provid] tra9+ ,"p ,b (     
title ,,iii ( ! ,public ,heal? ,s]vice  
,act 7#db ,u4,s4,c4 #bdc et seq471 z    
am5d$ by section #d1 is fur!r am5d$ by  
ins]t+ aft] section #cag,p-#a ! foll[+3 
#cag,p-#b4 ,wom5's heal? c>e provid]s   
demon/ration tra9+ project  7a7         
,e/abli%m5t ( program ,! ,secret>y %all 
e/abli% a demon/ration program to aw>d  
#c-ye> grants to eligible entities = !  
tra9+ ( physicians1 nurse practition]s1 
physician assi/ants1 & o!r heal? c>e    
provid]s relat$ to life-sav+ brea/ &    
gynecologic canc] scre5+ = wom51 includ+
 appropriate foll[-up c>e & scre5+ =    
abnormal results4  7b7 ,purpose ,!      
purpose ( ! program "u ?is section is to
 enable ea* grant recipi5t to-- 7#a7    
provide to lic5s$ physicians1 nurse     
practition]s1 physician assi/ants1 & o!r
 heal? c>e provid]s1 ?r\gh cl9ical      
tra9+1 education1 & practice1 ! mo/     
up-to-date cl9ical guidel9es1 rese>*1 & 
recomm5dations adopt$ by ! ,unit$ ,/ates

 ,prev5tive ,s]vices ,task ,=ce 9 ! area
 ( prev5tive canc] scre5+ = brea/ &     
gynecologic canc]s1 includ+ = wom5 )    
d5se brea/ tissue2  7#b7 e/abli% a model
 ( tra9+ = physicians1 nurse            
practition]s1 physician assi/ants1 & o!r
 heal? c>e provid]s t specialize 9      
wom5's heal? c>e1 ) a specific focus on 
brea/ & gynecologic canc] scre5+ & foll[
 up c>e1 t may be replicat$ nationwide2 
7#c7 tra9 physicians1 nurse             
practition]s1 physician assi/ants1 & o!r
 heal? c>e provid]s to s]ve rural &     
und]s]v$ communities1 l[-income         
communities1 & communities ( color 9    
brea/ & gynecologic canc] scre5+ & foll[
 up c>e2 &  7#d7 provide implicit bias1 
cultural compet5cy1 & pati5t-c5t]$      
communication tra9+ cov]+ ! ways 9 :i*  
/ructural racism & discrim9ation manife/
 )9 ! m$ical field & p]petuate racial   
disp>ities 9 gynecologic canc] incid5ce 
& mortality rates & h[ to communicate ) 
pati5ts ?r\gh a kn[l$geable & culturally
 empa!tic l5s4  7c7 ,eligible entities  

,to be eligible to receive a grant "u   
?is section1 an entity %all be-- 7#a7 an
 entity t receives fund+ "u section     
#ajja or section #ajjc2  7#b7 an        
ess5tial community provid]1 z def9$ 9   
section #aef4bce ( title #de1 ,code (   
,f$]al ,regulations 7or any successor   
regulations71 t is prim>ily engag$ 9    
family plann+2  7#c7 an entity t        
furni%es items or s]vices to individuals
 enroll$ 9 a ,/ate ,m$icaid program or  
waiv] ( su* a plan2 or  7#d7 an entity  
t1 at ! "t ( application1 provides canc]
 scre5+ s]vices "u ! ,national ,brea/ & 
,c]vical ,canc] ,e>ly ,detection        
,program "u title ,,xv4  4  #f4 ,/udy & 
report to ,congress on increas$ canc]   
scre5+ = wom5  7a7 ,9 g5]al ,! ,secret>y
 ( ,heal? & ,human ,s]vices 7ref]r$ to 9
 ?is section z ! ,secret>y7 %all-- 7#a7 
conduct a /udy 7& p]iodically update su*
 /udy7 on increas$ access to wom5's     
prev5tive life-sav+ canc] scre5+s across
 ! ,unit$ ,/ates2 &  7#b7 n lat] ?an #b 
ye>s aft] ! date ( enactm5t ( ?is ,act1 

& e #e ye>s !reaft]1 submit a report to 
,congress on su* /udy4  7b7 ,cont5ts ,! 
/udy & reports "u subsection 7a7 %all   
include-- 7#a7 an analysis ( brea/ &    
gynecologic canc] rates among wom5      
across all #ej ,/ates1 ! ,di/rict (     
,columbia1 & ! t]ritories1 includ+ by   
geographic area1 income1 employm5t      
/atus1 race1 e?nicity1 & /atus (        
insurance cov]age2  7#b7 an analysis (  
canc] scre5+s provid$ by wom5's heal?   
c>e provid]s across all #ej ,/ates1 !   
,di/rict ( ,columbia1 & ! t]ritories1   
includ+ cl9ical brea/ exams1 o!r scre5+ 
= brea/ canc]1 & scre5+ = c]vical canc]1
 ov>ian canc]1 & o!r gynecologic canc]s2
  7#c7 ) respect to wom5 )              
disproportionate rates ( gynecological  
canc]s1 or :o are less likely to receive
 scre5+s & c>e1 & brok5 d[n by          
categories ( su* wom5 t include ,black  
wom52 ,hispanic & ,lat9a wom52 ,asian   
,am]ican1 ,native ,hawaiian1 & ,pacific 
,isl&] wom52 old] wom52 un9sur$ &       
und]9sur$ wom52 & wom5 liv+ 9 rural &   

und]s]v$ areas-- 7,a7 an analysis ( !   
aw>5ess1 availability1 & uptake ( brea/1
 c]vical1 ov>ian1 & o!r gynecological   
canc] scre5+ options2  7,b7 an analysis 
( h[ access to heal? c>e provid]s tra9$ 
"u ! program describ$ 9 section         
#cag,p-#b ( ! ,public ,heal? ,s]vice    
,act1 z add$ by section #e1 9 comp>ison 
to o!r heal? c>e provid]s1 increas$ e>ly
 detection ( canc] & quality ( canc] c>e
 = su* wom52 &  7,c7 recomm5dations =   
increas+ scre5+ rates = su* wom5 :o are 
less likely to be scre5$ or treat$ =    
brea/1 c]vical1 ov>ian1 & o!r           
gynecological canc]s2  7#d7 an analysis 
( h[ /ructural racism impacts access to 
canc] scre5+ s]vices1 correlates to !   
developm5t ( brea/1 c]vical1 ov>ian1 &  
o!r gynecological canc]s1 & exac]bates  
heal? c>e disp>ities = ,black wom52     
,hispanic & ,lat9a wom52 ,asian         
,am]ican1 ,native ,hawaiian1 & ,pacific 
,isl&] wom52 & o!r wom5 ( color2  7#e7 9
 consultation ) ! ,comptroll] ,g5]al ( !
 ,unit$ ,/ates1 e/imat$ ,f$]al sav+s    

a*iev$ ?r\gh e>ly detection ( brea/ &   
gynecologic canc]s2  7#f7 recomm5dations
 by ! ,secret>y ) respect to ! ne$ =    
cont9u$ increas$ access to wom5's heal? 
c>e provid]s1 su* z ! entities describ$ 
9 section #cag,p-#b7;c7 ( ! ,public     
,heal? ,s]vice ,act1 z add$ by section  
#e1 :o provide prev5tive c>e1 includ+   
life-sav+ canc] scre5+s2 &  7#g7 an     
evaluation ( ! demon/ration project on  
co-te/+ = human papillomavirus & c]vical
 canc] "u section #cag,p-#c ( ! ,public 
,heal? ,s]vice ,act1 z add$ by section  
#g1 includ+ ! results ( ! demon/ration  
project & a recomm5dation on :e!r       
expansion ( ! co-te/+ model describ$ 9  
su* section #cag,p-#c w\ld be advis$ 9  
ord] to promote e>ly int]v5tion1 scre5+ 
uptake1 & r$uce c]vical canc] dea?s &   
racial & e?nic disp>ities4  #g4         
,demon/ration project on co-te/+ = human
 papillomavirus & c]vical canc] ,"p ,b (
 title ,,iii ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bdc et seq471 z    
am5d$ by section #e1 is fur!r am5d$ by  

ins]t+ aft] section #cag,p-#b ! foll[+3 
#cag,p-#c4 ,demon/ration project on     
co-te/+ = human papillomavirus & c]vical
 canc]  7a7 ,9 g5]al ,! ,secret>y1 9    
consultation ) ! ,director ( ! ,c5t]s = 
,disease ,control & ,prev5tion & !      
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 z appropriate1  
%all e/abli% a #b-ye> demon/ration      
project on increas+ ! c]vical canc]     
scre5+ co-te/+ ( human papillomavirus & 
c]vical cytology 7commonly ref]r$ to z  
,pap te/s7 to develop models = increas+ 
! rates ( co-te/+ among wom5 )          
disproportionate rates ( c]vical canc]1 
includ+ ,black wom52 ,hispanic & ,lat9a 
wom52 & ,asian ,am]ican1 ,native        
,hawaiian1 & ,pacific ,isl&] wom54  7b7 
,use ( funds ,entities receiv+ an aw>d  
"u ?is section %all use su* aw>d to--   
7#a7 increase access to co-te/+ ( human 
papillomavirus te/+ & c]vical canc]     
among pati5ts ) disproportionate rates (
 c]vical cytology1 includ+ ,black wom52 
,hispanic & ,lat9a wom52 & ,asian       

,am]ican1 ,native ,hawaiian1 & ,pacific 
,isl&] wom52  7#b7 support culturally & 
l+ui/ically appropriate deliv]y models  
to su* pati5ts1 includ+ ?r\gh !         
provision ( int]pretation s]vices2 or   
7#c7 provide o!r s]vices to improve     
heal? outcomes ) respect to su* pati5ts4
  7c7 ,prioritization ,9 mak+ aw>ds "u  
?is section1 ! ,secret>y %all give      
priority to eligible entities s]v+      
l[-income1 un9sur$1 or m$ically und]s]v$
 populations 7z def9$ 9 section         
#ccj7;b77#c77 or populations )          
hi/orically l[ rates ( su* co-te/+1 su* 
z old] wom54  7d7 ,eligible entities ,to
 be eligible to receive a grant "u ?is  
section1 an entity %all be an entity    
describ$ 9 section #cag,p-#b7;c74  4