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                                                       Calendar No. 530
109th Congress                                                   Report
                                 SENATE
 2d Session                                                     109-290

======================================================================



 
          BREAST CANCER AND ENVIRONMENTAL RESEARCH ACT OF 2006

                                _______
                                

                 July 24, 2006.--Ordered to be printed

                                _______
                                

Mr. Enzi, from the Committee on Health, Education, Labor, and Pensions, 
                        submitted the following

                              R E P O R T

                         [To accompany S. 757]

    The Committee on Health, Education, Labor, and Pensions, to 
which was referred the bill (S. 757) to amend the Public Health 
Service Act to authorize the Director of the National Institute 
of Environmental Health Sciences to make grants for the 
development and operation of research centers regarding 
environmental factors that may be related to the etiology of 
breast cancer, having considered the same, reports favorably 
thereon with an amendment in the nature of a substitute and 
recommends that the bill (as amended) do pass.

                                CONTENTS

                                                                   Page
  I. Purpose and summary of the bill..................................1
 II. Background and need for legislation..............................2
III. Legislative history and committee action.........................3
 IV. Explanation of bill and committee views..........................5
  V. Cost estimate....................................................6
 VI. Application of law to the legislative branch.....................8
VII. Regulatory impact statement......................................8
VIII.Section-by-section analysis......................................8

 IX. Changes in existing law..........................................9

                   I. Purpose and Summary of the Bill

    S. 757, the Breast Cancer and Environmental Research Act of 
2006, does the following:
           Creates a national strategy to conduct 
        research into the possible links between breast cancer 
        and the environment;
           Establishes a peer-reviewed grant program 
        within the National Institutes of Health to fund 
        collaborative Centers that would work across 
        institutions, across disciplines, and with community 
        organizations to study environmental factors that may 
        cause breast cancer; and
           Includes researchers and consumers in an 
        Advisory Panel that will make recommendations on how to 
        determine the grant mechanisms, peer review criteria 
        and, once peer review is conducted, make funding 
        allocation recommendations to the Secretary.
    This legislation would authorize the Secretary of Health 
and Human Services, working through the Director of the 
National Institutes of Health (NIH), to develop a research 
program of peer-reviewed grants for the establishment of 
collaborative Centers of research to study environmental 
factors that are believed to contribute to the development of 
breast cancer. The Secretary will establish an Advisory Panel 
that will: develop a national strategy regarding the 
collaborative Centers; make recommendations on how to design 
the grant mechanisms and peer review criteria; and, after peer 
review has been carried out, make recommendations for 
allocation of funds to the Centers to prevent unnecessary 
duplication of research and ensure consistency with the 
national strategy and its programmatic priorities.
    Under a competitive process of peer-reviewed research that 
includes trained consumers who represent a breast cancer 
constituency in the decisionmaking process, the NIH Director, 
in cooperation with the Director of the National Institute of 
Environmental Health Sciences (NIEHS) and the Director of the 
National Cancer Institute (NCI), would award grants to conduct 
multi-institutional and multi-disciplinary research using a 
broad definition of environment through a national network of 
collaborative Centers. The bill requires each Center to be 
multi-institutional and to establish and maintain 
collaborations at all levels with community organizations in 
its area of influence, including those community organizations 
that represent a breast cancer constituency. Each collaborative 
Center will be required to network with the other funded 
Centers. Up to eight collaborative, multi-institutional Centers 
may be funded each year.

              II. Background and Need for the Legislation

    Estimates by the American Cancer Society indicate that a 
woman in the United States has a 1 in 8 chance of developing 
invasive breast cancer during her lifetime. This risk was about 
1 in 11 in 1975. In fact, more women in the United States are 
living with breast cancer than any other cancer (excluding skin 
cancer). Approximately 3 million women in the U.S. are living 
with breast cancer: about 2.3 million have been diagnosed with 
the disease and an estimated 1 million do not yet know they 
have it. In 2006, it is estimated that 274,900 new cases of 
breast cancer will be diagnosed among women in the United 
States: 212,920 invasive and 61,980 cases of in situ breast 
cancer. Breast cancer is the second leading cause of cancer 
death for women in the U.S.; approximately 40,970 women in the 
U.S. will die in 2006. Breast cancer is the leading cause of 
cancer death for U.S. women between the ages of 20 and 59, and 
the leading cause of cancer death for women worldwide. While 
breast cancer is about 100 times more common in women, it is 
important to note that the American Cancer Society estimates 
that in 2006, about 1,720 new cases of invasive breast cancer 
will be diagnosed among men in the United States.
    Despite these statistics, we still do not know what causes 
breast cancer. We do know that all women are at risk for breast 
cancer. We also know that about 90 percent of women who develop 
breast cancer do not have a family history of the disease. 
Although scientists have discovered some risk factors for 
breast cancer, the known risk factors account for only a small 
percentage (  30 percent) of breast cancer cases. There are no 
proven interventions to prevent breast cancer and there is no 
cure.
    Because many women, and men, have no family history, or 
known genetic links to breast cancer it is generally believed 
that the environment plays a role in the development of breast 
cancer. However, we still do not understand the extent of that 
role. The committee recognizes the need to create a national 
strategy to study environmental factors so that we can learn 
what, if anything, in our environment might be contributing to 
the breast cancer epidemic and lead to preventive actions.
    This legislation came about as a result of two 
Environmental Policy Summits sponsored by the National Breast 
Cancer Coalition (NBCC). At the first NBCC Environmental Policy 
Summit in 1998, more than 50 experts, including scientists, 
advocates, government officials, and policy-makers, came 
together to begin developing a strategy for studying the links 
between breast cancer and the environment. Participants agreed 
that in order to truly understand what causes breast cancer, 
and how to prevent it, we must first focus on formulating the 
right questions. Summit participants emphasized the need to 
correct the persistent under-funding of research in this 
important area, while also increasing opportunities for 
innovative research. NBCC held a second summit in 2000, where 
more specific recommendations were made in order to accomplish 
this goal. The Breast Cancer and Environmental Research Act was 
developed in order to satisfy the recommendations and 
accomplish the goals set forth at both Summits.

             III. Legislative History and Committee Action

    The Breast Cancer and Environmental Research Act was first 
introduced in the 106th Congress. In 1999 Representative Nita 
Lowey introduced the bill, and in the Senate it was introduced 
in 2000 by Senators Lincoln Chafee and Harry Reid. By the end 
of 2000, the proposed legislation had yielded 16 Senate 
cosponsors and 98 House cosponsors.
    In the 107th Congress, it was reintroduced by Senators 
Chafee and Reid, and Representatives Lowey and Sue Myrick. In 
2001, NBCC advocate Gail Frankel testified at a Senate 
Environment and Public Works Field Hearing, hosted by Senator 
Hillary Rodham Clinton and attended by Senators Chafee and 
Reid, in Garden City, NY regarding the need for such 
legislation:

          We all wonder what causes breast cancer. I, too, have 
        questions about what caused my breast cancer. Diagnosed 
        at 53, I was told that even though my mother died at 
        age 48 from the disease, my breast cancer was unlikely 
        to be due to an inherited genetic defect since 
        inherited cancer usually shows up at anearlier age in 
offspring. No other high risk factors applied to me. Did my diagnosis 
have something to do with where I live? The sad truth is nobody knows; 
there is no conclusive evidence about what causes this disease.

    In 2002, the Senate Labor HHS Appropriations Subcommittee 
agreed that a strategic approach--like the one taken in this 
legislation--is needed to study breast cancer and the 
environment, and included the following language in their 
committee report:

          The committee recognizes the serious lack of research 
        on the relationship between the environment and breast 
        cancer, and believes that it is essential for the 
        Institute to support such research. The committee 
        understands that the Institute will establish a Breast 
        Cancer and Environmental Research Advisory Board to 
        make recommendations to the director with regard to the 
        development of Breast Cancer and Environmental Research 
        Centers. The committee is aware of the tremendous 
        success of the DOD Breast Cancer Research Program and 
        its grant process. The committee expects the Advisory 
        Board to integrate a peer review and planning process 
        along the lines of the DOD integration panel. The 
        committee is pleased that the Advisory Board will 
        include representatives from the breast cancer 
        community who have had breast cancer. The committee 
        further strongly urges the NIEHS to establish centers 
        to conduct multi-disciplinary and multi-institution 
        research on environmental factors that may be related 
        to breast cancer.

    The legislation was re-introduced in the 108th Congress by 
Senators Chafee and Reid, and Representatives Lowey and Myrick. 
By the end of that Congress, the number of Congressional 
cosponsors for the Breast Cancer Environmental Research Act 
increased to 62 in the Senate and 210 in the House. In 2003, 
the following was included in the fiscal year 2003 Labor-HHS 
Conference Report language:

          The conferees commend NIEHS for its recent efforts to 
        bolster research initiatives on the environmental 
        influences of breast cancer. The conferees recognize 
        the serious lack of research on the relationship 
        between the environment and breast cancer, and believe 
        that it is important for the Institute to support such 
        research. The conferees urge the Institute to establish 
        a group of breast cancer and environmental research 
        advisers to make recommendations to the Director with 
        regard to the support of the breast cancer and 
        environmental research, and to include in the group 
        representatives from the breast cancer community who 
        have had breast cancer. The conferees request an update 
        at the fiscal year 2004 hearings on the progress in 
        establishing an advisory group. The conferees encourage 
        NIEHS to consider establishing centers to conduct 
        multi-disciplinary and multi-institution research on 
        environmental factors that may be related to breast 
        cancer.

    In response to the fiscal year 2003 Labor-HHS Conference 
Report language, NIEHS announced a collaborative program with 
NCI to fund four research Centers. The specific goal of these 
Centers is focused on the environmental determinants of puberty 
and mammary gland development that may increase a woman's risk 
of breast cancer, which is only one of many questions of 
interest in this field. Funding for these Centers combined is 
$5 million per year over 7 years, for a total of $35 million. 
The current Centers do not have an overall national strategy 
for the field of potential environmental links to breast 
cancer. Conversely, the strategy developed by the Panel and 
implemented by the Centers in this legislation will expand the 
field to all questions that need to be studied to determine any 
links between the environment and breast cancer.
    In the 109th Congress, the legislation was once again re-
introduced by Senators Chafee, Reid, Orrin Hatch, Hillary 
Rodham Clinton, and Jim Talent in the Senate, and by 
Representatives Lowey, Myrick, Charlie Bass, and Lois Capps. 
The cosponsorship has reached 65 Senators and 244 
Representatives. After accepting a substitute amendment offered 
by Senator Enzi and cosponsored by Senators Kennedy, Hatch, 
Clinton, DeWine, Jeffords, Murray, Mikulski, and Reid, the 
Committee on Health, Education, Labor, and Pensions reported 
the bill favorably by unanimous voice vote on June 28, 2006.

              IV. Explanation of Bill and Committee Views

    This legislation is based on the successful Department of 
Defense Peer Reviewed Breast Cancer Research Program (DOD 
BCRP), which has been a model program for innovative breast 
cancer research. The structure of the DOD BCRP was based in 
large part from recommendations in a report issued by the 
Institute of Medicine at the request of the U.S. Army. The DOD 
Program's unique and highly effective structure, its focus on 
innovation and relevance, its accountability to the public, and 
its ability to focus on important funding and knowledge gaps, 
are important characteristics that would be replicated at the 
NIH through this legislation.
    The Breast Cancer and Environmental Research Act includes 
this effective review structure, involving consumers in the 
Advisory Panel as well as in peer review. Consumers are defined 
as educated advocates who represent a constituency of 
individuals who have had breast cancer. The Panel develops and 
implements an overall structure that seeks to create a 
comprehensive strategy for studying the linkage between breast 
cancer and the environment. When developing this strategy, it 
is important to include innovative mechanisms and research 
proposals from a global research community.
    Specifically, the Panel's duties would include:
           recommendations for research investment 
        strategy;
           advice on the content and type of 
        solicitation announcements and on the timing and number 
        of solicitations;
           recommendations on proposal format;
           recommendations for review criteria of 
        research proposals to be applied by peer review 
        committees;
           assistance in overall program evaluation;
           budget modifications of proposals 
        recommended for funding;
           recommendations on whether funds should be 
        transferred from one category to another;
           recommendations for selection of proposals 
        for funding by matching scientific merit from peer 
        review with the programmatic goals set for the program; 
        and
           recommendations for dissemination of 
        information on program process.
    The Panel would first develop and recommend to the 
Secretary, a strategy for the grant mechanisms and the peer 
review criteria. After peer review committees review and score 
the grant proposals, the Panel would then make recommendations 
to the Secretary regarding the allocations for the grants, 
ensuring the grants fulfill the goals of the national strategy. 
The Panel's recommendations will prevent unnecessary 
duplication of research and confirm that the grants address a 
broad range of issues and form the basis of the national 
strategy. The Panel will be made up of researchers and other 
health professionals, as well as consumers, who represent 
organizations of individuals who have had breast cancer.
    The Centers, established through the grant process, will be 
made up of collaborative groups of research scientists from 
various institutions, and different scientific disciplines as 
well as community organizations representing individuals with 
breast cancer who come together to address the issue of 
exploring the links between breast cancer and the environment. 
The Centers will develop innovative approaches to study 
knowledge gaps of research with regard to the environment and 
breast cancer. Each Center funded by the grants will be 
expected to collaborate with the other Centers, and to report 
to the Director of NIH, in order for the highest level of 
cooperation and accountability to the public and to eliminate 
unnecessary duplication of research.

                            V. Cost Estimate

                                     U.S. Congress,
                               Congressional Budget Office,
                                     Washington, DC, July 14, 2006.
Hon. Mike Enzi,
Chairman, Committee on Health, Education, Labor, and Pensions, U.S. 
        Senate, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 757, the Breast 
Cancer and Environmental Research Act of 2006.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Sarah Evans.
            Sincerely,
                                          Donald B. Marron,
                                                   Acting Director.
    Enclosure.

S. 757--Breast Cancer and Environmental Research Act of 2006

    Summary: S. 757 would amend the Public Health Service Act 
to authorize the Director of the National Institutes of Health 
(NIH) to make grants to public or nonprofit organizations to 
develop and operate centers that would conduct research on 
environmental factors that may contribute to the development of 
breast cancer. The bill also would direct the Secretary of 
Health and Human Services (HHS) to establish a Breast Cancer 
and Environmental Research Panel, whose task would be to 
develop research priorities and make recommendations for the 
program.
    For the activities described above, S. 757 would authorize 
the appropriation of $30 million each fiscal year from 2007 
through 2012. CBO estimates that implementing the bill would 
cost $10 million in 2007 and $123 million over the 2007-2011 
period, assuming the appropriation of the authorized amounts. 
Enacting S. 757 would have no effect on direct spending or 
revenues.
    The bill contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would impose no costs on state, local, or tribal 
governments.
    Estimated cost to the Federal Government: The estimated 
budgetary impact of S. 757 is shown in the following table. The 
costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                                       By fiscal year, in millions of dollars--
                                                                    --------------------------------------------
                                                                       2007     2008     2009     2010     2011
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION

Authorization Level................................................       30       30       30       30       30
Estimated Outlays..................................................       10       26       29       29       29
----------------------------------------------------------------------------------------------------------------

    Basis of estimate: Two institutes of the NIH, the National 
Cancer Institute and the National Institute of Environmental 
Health Sciences (NIEHS), currently support four collaborative 
Breast Cancer and the Environment Research Centers that study 
how chemical, physical, and social factors in the environment 
affect the development of breast cancer. According to officials 
at NIEHS, those institutes spent approximately $5 million on 
those research centers in fiscal year 2005 and plan to spend a 
similar amount each year through fiscal year 2009. S.757 would 
provide statutory authorization for similar Breast Cancer and 
Environmental Research Centers of Excellence administered 
through the NIH. The bill would authorize those centers for 
fiscal years 2007 through 2012.
    In addition, S. 757 would require the Secretary of HHS to 
establish within the NIH a nine-member Breast Cancer and 
Environmental Research Panel, which would set research 
priorities and make recommendations for the Centers for 
Excellence program.
    For carrying out the above activities, the bill would 
authorize the appropriation of $30 million for each of the 
fiscal years 2007 through 2012. Such authorization would be in 
addition to any currently authorized appropriations for those 
activities. For this estimate, CBO assumes that S. 757 will be 
enacted near the start of fiscal year 2007 and that the 
authorized amounts will be appropriated for each year. Using 
historical patterns of spending for similar programs, CBO 
estimates that implementing the bill would cost $10 million in 
2007 and $123 million over the 2007-2011 period.
    Intergovernmental and private-sector impact: S. 757 
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; Sarah Evans. Impact on 
State, Local, and Tribal Governments: Leo Lex. Impact on the 
Private Sector: Jennifer Doleac.
    Estimate approved by: Robert A. Sunshine, Assistant 
Director for Budget Analysis.

            VI. Application of Law to the Legislative Branch

    S. 757 amends the PHSA to authorize this grant program.

                    VII. Regulatory Impact Statement

    This legislation requires the Secretary, working through 
the Director of NIH, to establish grants for the development 
and operation of research Centers regarding environmental 
factors that may be related to the etiology of breast cancer. 
The committee has determined that the bill will not have a 
significant regulatory impact.

                   VIII. Section-by-Section Analysis


Sec. 1. Short title

    The Breast Cancer and Environmental Research Act of 2006.

Sec. 2. National Institutes of Health; awards for development and 
        operation of research centers regarding environmental factors 
        related to breast cancer

    Instructs the Secretary, acting through the Director of 
NIH, and working in cooperation with the Directors of NIEHS and 
NCI to establish a Breast Cancer and Environmental Research 
Panel and make grants to develop and operate collaborative 
Centers that would conduct research on environmental factors 
that may be linked to the development of breast cancer.
    Establishes the Breast Cancer and Environmental Research 
Panel that will be made up of six researchers and other health 
professionals, and three members from the general public who 
are breast cancer survivors, or their representatives. The 
Secretary may choose to include non-voting, ex-officio members 
as well. The Panel members will elect the Chair of the Panel. 
The Panel will meet as often as the Director of NIH or the 
Chair of the Panel determine, but no less than once a year.
    The Panel duties include developing a comprehensive 
strategy regarding collaborative Centers, making 
recommendations to the Secretary with respect to the 
mechanisms, peer review criteria, and allocations for the 
Centers, assisting in the overall program evaluation, and 
providing recommendations for disseminating information on the 
process of the program.
    The Centers funded by the grants will develop innovative 
approaches to study unexplored or under-explored areas of the 
environment and breast cancer. They will also be responsible 
for identifying key research questions, and knowledge gaps in 
this area. In addition, the Centers will address key issues 
regarding environmental factors that may be related to breast 
cancer, and as a result, contribute to a strategy to address 
those factors. Each Center must include community organizations 
in the geographic areas served by the Center that represent 
individuals with breast cancer. These organizations would be 
integral collaborators involved at all levels of the decision-
making and research in each Center. The Centers will also need 
to communicate regularly among themselves, and, at the 
direction of the Director of NIH, submit reports on their 
activities.
    The Centers would be funded for up to 5 years. The funding 
may be extended up to 5 more years after a peer review 
committee has recommended to the Director of NIH that the 
Center's funding should be extended. Finally, the Director of 
NIH will be responsible for ensuring, to the extent 
practicable, that the Centers are distributed equitably across 
the country.
    Authorization of Appropriations--$30,000,000 per year for 5 
years is authorized by this legislation.

                      IX. Changes in Existing Law

    In compliance with rule XXVI paragraph 12 of the Standing 
Rules of the Senate, the following provides a print of the 
statute or the part or section thereof to be amended or 
replaced (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 IV--NATIONAL RESEARCH INSTITUTES

                 PART A--NATIONAL INSTITUTES OF HEALTH


           ORGANIZATION OF THE NATIONAL INSTITUTES OF HEALTH

    Sec. 401. * * *

           *       *       *       *       *       *       *

    Sec. 404A. * * *

           *       *       *       *       *       *       *

    Sec. 404G. (a) Cooperative Agreements and Grants.--
          (1) In general.--* * *

           *       *       *       *       *       *       *


SEC. 404H. RESEARCH CENTERS REGARDING ENVIRONMENTAL FACTORS RELATED TO 
                    BREAST CANCER.

    (a) In General.--The Secretary, acting through the Director 
of NIH, based on recommendations from the Breast Cancer and 
Environmental Research Panel established under subsection (b) 
(referred to in this section as the `Panel'), shall make grants 
to public or nonprofit private entities for the development and 
operation of collaborative, multi-institutional centers for the 
purpose of conducting multidisciplinary and multi-institutional 
research on environmental factors that may be related to the 
etiology of breast cancer. Each such center shall be known as a 
Breast Cancer and Environmental Research Center of Excellence.
    (b) Breast Cancer and Environmental Research Panel.--
          (1) Establishment.--The Secretary shall establish 
        within the National Institutes of Health a Breast 
        Cancer and Environmental Research Panel.
          (2) Composition.--The Panel shall be composed of--
                  (A) 9 members to be appointed by the 
                Secretary, of which--
                          (i) six members shall be appointed 
                        from among physicians and other health 
                        professionals, who--
                                  (I) are not officers or 
                                employees of the United States;
                                  (II) represent multiple 
                                disciplines, including 
                                clinical, basic, and public 
                                health sciences;
                                  (III) represent different 
                                geographical regions of the 
                                United States;
                                  (IV) are from practice 
                                settings, academia, or other 
                                research settings; and
                                  (V) are experienced in peer 
                                review; and
                          (ii) three members shall be appointed 
                        from the general public who are 
                        representatives of individuals who have 
                        had breast cancer and who represent a 
                        constituency; and
                  (B) such nonvoting, ex officio members as the 
                Secretary determines to be appropriate.
          (3) Chairperson.--The members of the Panel appointed 
        under paragraph (2)(A) shall select a chairperson from 
        among such members.
          (4) Meetings.--The Panel shall meet at the call of 
        the chairperson or upon the request of the Director of 
        NIH, but in no case less often than once each year.
          (5) Duties.--The Panel shall--
                  (A) develop a comprehensive strategy 
                concerning collaborative centers that would--
                          (i) result in innovative approaches 
                        to study unexplored or underexplored 
                        areas of the environment and breast 
                        cancer;
                          (ii) outline key research questions, 
                        methodologies, and knowledge gaps 
                        concerning environmental factors that 
                        may be related to the etiology of 
                        breast cancer;
                          (iii) outline key issues concerning 
                        environmental factors that may be 
                        related to the etiology of breast 
                        cancer; and
                          (iv) result in an overall strategy to 
                        address environmental factors related 
                        to breast cancer;
                  (B) make recommendations to the Secretary 
                with respect to the mechanisms, peer review 
                criteria, and allocations under this section;
                  (C) assist in the overall program evaluation; 
                and
                  (D) make recommendations for the 
                dissemination of information on program 
                process.
    (c) Collaboration With Community.--Each center under 
subsection (a) shall include community organizations in the 
geographic area served by the center, including those that 
represent women with breast cancer, as integral collaborators 
involved at all levels of the decision-making and research in 
such center.
    (d) Coordination of Centers; Reports.--The Director of NIH 
shall, as appropriate, provide for the coordination of 
information among centers under subsection (a) and ensure 
regular communication between such centers, and may require the 
periodic preparation of reports on the activities of the 
centers and the submission of the reports to the Director.
    (e) Required Consortium--Each center under subsection (a) 
shall be formed from a consortium of cooperating institutions 
and community groups, meeting such requirements as may be 
prescribed by the Director of NIH. Each center shall require 
collaboration among highly accomplished scientists, other 
health professionals and advocates of diverse backgrounds from 
various areas of expertise.
    (f) Duration of Support.--Support of a center under 
subsection (a) may be for a period not exceeding 5 years. Such 
period may be extended for one or more additional periods not 
exceeding 5 years if the operations of such center have been 
reviewed by an appropriate technical and scientific peer review 
group established by the Director of NIH and if such group has 
recommended to the Director that such period be extended.
    (g) Geographic Distribution of Centers.--The Director of 
NIH shall, to the extent practicable, provide for an equitable 
geographical distribution of centers under this section.
    (h) Authorization of Appropriations.--For the purpose of 
carrying out this section, there is authorized to be 
appropriated $30,000,000 for each of the fiscal years 2007 
through 2012. Such authorization is in addition to any other 
authorization of appropriations that is available for such 
purpose.

           *       *       *       *       *       *       *