[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4824 Introduced in House (IH)]







107th CONGRESS
  2d Session
                                H. R. 4824

   To provide for various programs and activities to respond to the 
                   problem of asthma in urban areas.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 22, 2002

  Mr. Towns introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To provide for various programs and activities to respond to the 
                   problem of asthma in urban areas.

    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 ``Urban Asthma Assistance Act''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Asthma is a serious chronic condition affecting an 
        estimated 14,000,000 to 15,000,000 individuals in the United 
        States, including almost 5,000,000 children.
            (2) Asthma accounts for an estimated 3 million lost 
        workdays for adults and 10.1 million lost school days in 
        children annually. Asthma is one of the Nation's most common 
        and costly diseases. Over the past 20 years mortality, 
        morbidity and hospital discharge rates attributed to asthma 
        have substantially increased. Between 1979 and 1998, the age-
        adjusted mortality rate increased 56 per-cent while the 
        prevalence rate increased by almost 22 percent in males and 97 
        percent in females between 1982 and 1996.
            (3) Asthma is a chronic illness that is treatable with 
        ambulatory and specialty care, but over 43 percent of its 
        economic impact comes from use of emergency rooms, 
        hospitalization, and death.
            (4) Certain pests, such as cockroaches and rodents, are 
        known to create public health problems and proliferate at 
        higher rates in urban areas. These pests may spread infectious 
        disease and contribute to the worsening of chronic respiratory 
        illnesses, including asthma.
            (5) Research supported by the National Institutes of Health 
        demonstrated that the cockroach, rodent, house dust mite, and 
        mold allergens, as well as tobacco smoke and feathers, are 
        important environmental causes of asthma-related illness and 
        hospitalization among children in inner-city areas of the 
        United States.
            (6) Morbidity and mortality related to childhood asthma are 
        disproportionately high in urban areas.
            (7) In 1996 the prevalence rate in whites was 53.5 per 
        1,000 persons while the prevalence rate in blacks was 69.6 per 
        1,000 persons. Both of these rates represent significant 
        differences from the rates reported in 1982, when they were 
        34.6 and 39.2 for whites and blacks, respectively.
            (8) In 1995, there were more than 1,800,000 emergency room 
        visits made for asthma-related attacks and among these, the 
        rate for emergency room visits was 48.8 per 10,000 visits among 
        whites and 228.9 per 10,000 visits among blacks. These 
        statistics confirm that our healthcare system encourages 
        emergency room and trauma care rather than prevention.
            (9) Hospitalization rates were highest for individuals 4 
        years old and younger, and were 10.9 per 10,000 visits for 
        whites and 35.5 per 10,000 visits for blacks.
            (10) Minority children living in urban areas are especially 
        vulnerable to asthma. In 1988, national prevalence rates were 
        26 percent higher for black children than for white children.
            (11) Asthma is the most common chronic illness in 
        childhood, afflicting nearly 5,000,000 children under age 18, 
        and costing an estimated $1,900,000,000 to treat those 
        children. The death rate for children age 19 and younger 
        increased by 78 percent between 1980 and 1993.
            (12) From 1979 to 1992, the hospitalization rates among 
        children due to asthma increased 74 percent. It is estimated 
        that more than 7 percent of children now have asthma.
            (13) Although asthma can occur at any age, about 80 percent 
        of the children who will develop asthma do so before starting 
        school.
            (14) From 1980 to 1994, the most substantial prevalence 
        rate increase for asthma occurred among children aged 0 to 4 
years (160 percent) and persons aged 5 to 14 years (74 percent).
            (15) Children aged 0 to 5 years who are exposed to maternal 
        smoking are 201 times more likely to develop asthma compared 
        with those free from exposure.
            (16) According to data from the 1988 National Health 
        Interview Survey (NHIS), which surveyed children for their 
        health experiences over a 12-month period, 25 percent of those 
        children reported experiencing a great deal of pain or 
        discomfort due to asthma either often or all the time during 
        the previous 12 months.
            (17) Asthma entails an annual economic cost to our nation 
        in direct health care costs of $8.1 billion; indirect costs 
        (lost productivity) add another $4.6 billion for a total of 
        $12.7 billion. Inpatient hospital services represented the 
        largest single direct medical expenditure, over $3.5 billion. 
        The value of reduced productivity due to loss of school days 
        represented the largest single indirect cost at $1.5 billion.
            (18) According to a 1995 National Institute of Health 
        workshop report, missed school days accounted for an estimated 
        cost of lost productivity for parents of children with asthma 
        of almost $1,000,000,000 per year.
            (19) Managing asthma requires a long-term, multifaceted 
        approach, including patient education, specialty care, life 
        skills training, nutrition counseling elimination or avoidance 
        of asthma triggers, pharmacologic therapy, and scheduled 
        medical follow-up.
            (20) In recognition of the growing public health crisis in 
        asthma, in 1999, the Centers for Disease Control and Prevention 
        developed the National Asthma Control Program within the 
        National Center for Environmental Health to determine the 
        incidence, prevalence, and circumstances of asthma cases.
            (21) Enhancing the available prevention, educational, 
        research, and treatment resources with respect to asthma in the 
        United States will allow our Nation to address more effectively 
        the problems associated with this increasing threat to the 
        health and well-being of our citizen.

SEC. 3. CDC'S URBAN ASTHMA PREVENTION PROGRAMS.

    (a) In General.--The Secretary of Health and Human Services, acting 
through the Director of the Centers for Disease Control and Prevention, 
shall provide, through the National Asthma Control Program within the 
National Center for Environmental Health, additional intervention 
program grants to address the incidence of asthma in urban areas.
    (b) Authorization of Appropriations.--For the purpose of carrying 
out subsection (a), there are authorized to be appropriated $15,000,000 
for fiscal year 2003, and such sums as may be necessary for each of the 
fiscal years 2004 through 2007.

SEC. 4. MEDICAID MODEL TREATMENT CENTERS DEMONSTRATION PROGRAM.

    Under the authority provided in section 1115 of the Social Security 
Act (42 U.S.C. 1315), the Secretary of Health and Human Services shall 
permit States under the medicaid program under title XIX of the Social 
Security Act to develop model asthma treatment centers demonstration 
programs that--
            (1) are based on the scientifically validated asthma 
        treatment models developed by the National Cooperative Inner-
        City Asthma Study supported by the National Institute of 
        Allergy and Infectious Diseases;
            (2) include education, screening, and treatment services 
        for children with asthma;
            (3) involve nonprofit organizations that can affect patient 
        beliefs, behavior, and outcomes;
            (4) include specialty care and access to a full range of 
        available treatments to minimize unwanted side effects; and
            (5) improve health outcomes while lowering overall health 
        care expenditures.

SEC. 5. CDC GUIDELINES REGARDING COORDINATION OF DATA.

    For the purpose of facilitating the utility and comparability of 
asthma data collected by State and local health departments, the 
Secretary of Health and Human Services, acting through the Director of 
the Centers for Disease Control and Prevention, shall develop and 
disseminate to such departments guidelines on the collection and 
reporting of such data.

SEC. 6. INCREASING NUMBER OF CDC HEALTH PROFESSIONALS SERVING IN ASTHMA 
              PROGRAMS.

    For the purpose of increasing the number of full-time equivalent 
employees of the Centers for Disease Control and Prevention who are 
health professionals and serve in asthma programs of such Centers, 
there are authorized to be appropriated $4,000,000 for fiscal year 
2003, and such sums as may be necessary for each of the fiscal years 
2004 through 2007.
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