[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5633 Introduced in House (IH)]







107th CONGRESS
  2d Session
                                H. R. 5633

 To ensure that children at highest risk for asthma are identified and 
                                treated.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 10, 2002

 Mr. Simmons (for himself, Mrs. Thurman, Mr. Smith of New Jersey, Mr. 
  Cummings, Mr. Blagojevich, and Mr. Hobson) introduced the following 
 bill; which was referred to the Committee on Energy and Commerce, and 
  in addition to the Committee on Education and the Workforce, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
 To ensure that children at highest risk for asthma are identified and 
                                treated.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Federal Asthma 
Assessment and State Tracking Act of 2002'' (FAAST Act).
    (b) Findings.--Congress finds the following:
            (1) Asthma summary.--Asthma is a serious chronic condition 
        affecting many Americans. Asthma accounts for an estimated 3 
        million lost workdays for adults and 10.1 million lost school 
        days in children annually. 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 percent while the 
        prevalence rate increased by almost 22 percent in males and 97 
        percent in females between 1982 and 1996.
            (2) Race-specific prevalence.--In 1996, the prevalence rate 
        of asthma 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.
            (3) Economic costs of asthma.--Asthma entails an annual 
        economic cost to the 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.

SEC. 2. ASTHMA SCREENING FOR EARLY HEAD START AND HEAD START PROGRAMS.

    (a) Early Head Start Programs.--Section 645A of the Head Start Act 
(42 U.S.C. 9840a) is amended by adding at the end the following:
    ``(h) Asthma Screening.--
            ``(1) In general.--An entity that receives assistance under 
        this section may carry out a program under which the entity--
                    ``(A) determines whether a child eligible to 
                participate in the program described in subsection (a) 
                has each received an asthma screening test using a test 
                that is appropriate for age and risk factors on the 
                enrollment of the child in the program; and
                    ``(B) in the case of a child who has not received 
                such an asthma screening test, ensures that the 
                enrolled child receives such a test either by referral 
                or by performing the test (under contract or 
                otherwise).
            ``(2) Reimbursement.--
                    ``(A) In general.--On the request of an entity that 
                performs or arranges for the performance of an asthma 
                screening test under paragraph (1) on a child who is 
                eligible for or receiving medical assistance under a 
                State plan under title XIX of the Social Security Act 
                (42 U.S.C. 1396 et seq.), the Secretary of Health and 
                Human Services, notwithstanding any other provision of, 
                or limitation under, title XIX of the Social Security 
                Act, shall reimburse the entity, from funds that are 
                made available under that title, for 100 percent of the 
                cost of the test and data reporting.
                    ``(B) Costs.--The costs of a test conducted under 
                this subsection--
                            ``(i) shall include reimbursement for 
                        testing devices and associated supplies 
                        approved for sale by the Food and Drug 
                        Administration and used in compliance with 
                        section 353 of the Public Health Service Act 
                        (42 U.S.C. 263a); and
                            ``(ii) shall include reimbursement for 
                        administering the tests and related services, 
                        as determined appropriate by the State agency.
            ``(3) Head start.--This subsection shall apply to Head 
        Start programs that include coverage, directly or indirectly, 
        for infants and toddlers under the age of 3 years.''.
    (b) Head Start Programs.--Section 642(b) of the Head Start Act (42 
U.S.C. 9837(b)) is amended--
            (1) in paragraph (10), by striking ``and'' at the end;
            (2) in paragraph (11), by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following:
            ``(12) with respect to an agency that elects to carry out a 
        program under section 645A(h), comply with the requirements of 
        such section in the case of each child eligible to participate 
        in the Head Start program to be carried out by the agency.''.

SEC. 3. ASTHMA SCREENING AND TREATMENT FOR CHILDREN ENROLLED IN PUBLIC 
              SCHOOLS.

    Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by adding at the end the following:

``SEC. 320B. ASTHMA SCREENING AND TREATMENT FOR CHILDREN ENROLLED IN 
              PUBLIC SCHOOLS.

    ``(a) Grants.--The Secretary shall award grants to eligible local 
educational agencies to enable such agencies to carry out asthma health 
screening and case management programs determined appropriate by the 
Secretary in accordance with the program elements described in 
subsection (d).
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), a local educational agency shall prepare and submit to 
the Secretary an application at such time, in such manner, and 
containing such information as the Secretary may require.
    ``(c) Preference.--In awarding grants under this section, the 
Secretary shall give preference to local educational agencies serving 
schools that are located in areas with a high incidence of childhood 
asthma or a high death rate associated with childhood asthma.
    ``(d) Program Elements.--Under an asthma program operated under a 
grant under this section, a local educational agency shall--
            ``(1) determine whether a child enrolled in a school in 
        which the program is in effect has received an asthma screening 
        test using a test that is appropriate for age and risk factors 
        on the enrollment of the child in the school;
            ``(2) in the case of a child who has not received an asthma 
        screening test, ensure that the child receives such a test 
        either by referral or by performing the test (under contract or 
        otherwise); and
            ``(3) in the case of a child determined to have asthma, 
        provide treatment or refer the child for treatment (including 
        case management) and education in the management of asthma.
    ``(e) Reimbursement.--
            ``(1) Children enrolled in or eligible for medicaid.--
                    ``(A) In general.--With respect to a child who is 
                eligible for or receiving medical assistance under a 
                State plan under title XIX of the Social Security Act 
                (42 U.S.C. 1396 et seq.) and who receives, or is 
                provided, a test, treatment, or education, under a 
                program established under subsection (a), the 
                Secretary, notwithstanding any other provision of, or 
                limitation under, such title XIX, including the payment 
                limitation commonly known as the `free care rule', 
                shall reimburse the local educational agency 
                administering such program from funds that are made 
                available under such title XIX for 100 percent of the 
                cost of the performance, arrangement, or provision and 
                data reporting.
                    ``(B) Costs.--The costs of a test conducted under 
                this section shall include reimbursement for--
                            ``(i) testing devices and associated 
                        supplies approved for sale by the Food and Drug 
                        Administration and used in compliance with 
                        section 353; and
                            ``(ii) administering the tests and related 
                        services, as determined appropriate by the 
                        State agency responsible for the administration 
                        of title XIX of the Social Security Act (42 
                        U.S.C. 1396 et seq.).
            ``(2) Children enrolled in or eligible for schip.--
                    ``(A) In general.--With respect to a child who is 
                eligible for or receiving child health assistance under 
                a State plan under title XXI of the Social Security Act 
                (42 U.S.C. 1397aa et seq.) and who receives, or is 
                provided, a test, treatment, or education under a 
                program established under subsection (a), the 
                Secretary, notwithstanding any other provision of, or 
                limitation under, such title XXI, or any other 
                provision of law (including the payment limitation 
                under title XIX commonly known as the `free care rule' 
                to the extent, if any, such limitation applies to the 
                State children's health insurance program established 
                under title XXI of that Act), shall reimburse the local 
                educational agency administering such program from 
                funds that are made available under such title XXI for 
                100 percent of the cost of the performance, 
                arrangement, or provision and data reporting.
                    ``(B) Costs.--The costs shall include the costs 
                described in paragraph (1)(B).
    ``(f) Definitions.--In this section, the terms `local educational 
agency', `elementary school', and `secondary school' have the meanings 
given such terms in section 9101 of the Elementary and Secondary 
Education Act of 1965 (20 U.S.C. 7801).
    ``(g) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section with respect to a child, and any 
data reporting with respect to the child, who is not eligible for 
coverage under title XIX or XXI of the Social Security Act, or is not 
otherwise covered under a health insurance plan, $15,000,000 for each 
of fiscal years 2003 through 2008.
    ``(h) Evaluations.--Not later than 4 years after the date of 
enactment of this section, the Secretary shall prepare and submit to 
the appropriate committees of Congress a report containing data related 
to whether grants provided under this section have ensured that 
children at the highest risk for asthma are identified and treated.''.

SEC. 4. PAYMENTS FOR SCREENING AND TREATMENT PROVIDED TO CHILDREN 
              ELIGIBLE UNDER MEDICAID OR SCHIP.

    (a) Medicaid.--Section 1903(c) of the Social Security Act (42 
U.S.C. 1396b(c)) is amended--
            (1) by inserting ``(1)'' after ``(c)''; and
            (2) by adding at the end the following:
    ``(2) Nothing in this title or any other provision of law, 
including the payment limitation commonly known as the `free care 
rule', shall be construed as prohibiting or restricting, or authorizing 
the Secretary to prohibit or restrict, payment under subsection (a) for 
medical assistance for covered services furnished to a child who is 
eligible for or receiving medical assistance under the State plan and 
who receives an asthma screening test, or is provided treatment or 
education in disease management relating to asthma, through a public 
elementary or secondary school, whether directly or indirectly, and 
regardless of whether the school participates in a program established 
under subsection (a) or (b) of section 1120B of the Elementary and 
Secondary Education Act of 1965.''.
    (b) SCHIP.--Section 2105 of the Social Security Act (42 U.S.C. 
1397ee) is amended by adding at the end the following:
    ``(g) Required Payment for Certain School-Based Services.--Nothing 
in this title or any other provision of law (including the payment 
limitation under title XIX commonly known as the `free care rule' to 
the extent, if any, such limitation applies to the program established 
under this title) shall be construed as prohibiting or restricting, or 
authorizing the Secretary to prohibit or restrict, payment under 
subsection (a) for child health assistance for covered services 
furnished to a child who is eligible for or receiving such assistance 
under the State child health plan and who receives an asthma screening 
test that is available to children receiving assistance under the State 
plan, or is provided treatment or education in disease management 
relating to asthma through a public elementary or secondary school, 
whether directly or indirectly, and regardless of whether the school 
participates in a program established under subsection (a) or (b) of 
section 1120B of the Elementary and Secondary Education Act of 1965.''.

SEC. 5. MODEL ASTHMA TREATMENTS CENTERS DEMONSTRATION PROGRAM.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall develop, in 
conjunction with State medicaid programs under title XIX of the Social 
Security Act, a demonstration program for model asthma treatment 
centers. In developing the program, the Secretary shall base the 
centers on the scientifically validated asthma treatment models 
developed by the Inner City Asthma Program sponsored by the National 
Institutes of Health. Such Program has successfully provided education, 
screening, and treatment services to children with asthma while 
improving health outcomes and lowering overall health care 
expenditures.
    (b) Location.--In developing the demonstration program under this 
section, the Secretary shall give priority to communities where the 
prevalence of uncontrolled asthma is high.
                                 <all>