[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1489 Introduced in Senate (IS)]








109th CONGRESS
  1st Session
                                S. 1489

   To amend the Public Health Service Act with regard to research on 
                    asthma, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 26, 2005

  Mrs. Clinton (for herself and Mr. DeWine) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act with regard to research on 
                    asthma, and for other purposes.

    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 ``Family Asthma Act''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) The number of people with asthma has more than doubled 
        from 1985 to 2005. According to the Centers for Disease Control 
        and Prevention, in 2002, more than 20,000,000 Americans had 
        been diagnosed with asthma, and an estimated 6,000,000 children 
        were suffering from asthma. By 2020, asthma is expected to 
        strike 1 in 14 Americans and 1 in 5 families.
            (2) According to the Centers for Disease Control and 
        Prevention, in 2002, more than 4,000 Americans died from 
        asthma. The Asthma and Allergy Foundation of America reports 
        that in the United States, 14 individuals die of asthma every 
        day. According to the Centers for Disease Control and 
        Prevention's National Center for Health Statistics, mortality 
        from asthma is higher among African-Americans and women.
            (3) According to the Centers for Disease Control and 
        Prevention, asthma accounts for nearly 500,000 hospitalizations 
        each year. More than 1,900,000 people are treated for asthma 
        attacks in hospital emergency departments each year.
            (4) The Morbidity and Mortality Weekly Report notes that 
        from 1980 to 1999, the number of physician office visits 
        increased from 5,900,000 to 10,800,000. There were higher rates 
        of physician office visits for African-Americans, females, and 
        children.
            (5) According to the National Heart Lung and Blood 
        Institute at the National Institutes of Health, the annual cost 
        of asthma to the United States is approximately 
        $16,100,000,000.
            (6) The Department of Education states that asthma is the 
        most commonly cited reason for school absences. According to 
        the Centers for Disease Control and Prevention, in 2002, more 
        than 14,000,000 school days and 11,800,00 work days were missed 
        as a result of asthma.
            (7) Asthma episodes can be triggered by both outdoor air 
        pollution and indoor air pollution, including pollutants such 
        as cigarette smoke and combustion by-productions. Asthma 
        episodes can also be triggered by indoor allergens such as 
        animal dander and outdoor allergens such as pollen and molds.
            (8) Public health interventions and medical care in 
        accordance with existing guidelines have been proven effective 
        in the treatment and management of asthma. Better asthma 
        management could reduce the numbers of emergency department 
        visits and hospitalizations due to asthma. Studies published in 
        medical journals have shown that asthma care from specialists 
        results in improved asthma outcomes at a lower cost.
            (9) The alarming rise in the prevalence of asthma, its 
        adverse effects on school attendance and productivity, its 
        costs for hospitalizations and emergency room visits, argue for 
        a more vigorous Federal leadership role, including increasing 
        awareness of asthma as a chronic illness, its symptoms, the 
        role of both indoor and outdoor environmental factors that 
        exacerbate the disease, and other factors that affect its 
        exacerbations and severity. The goals of the government and its 
        partners in the nonprofit and private sectors should include 
        reducing the number and severity of asthma attacks, its 
        financial burden, and the health disparities associated with 
        asthma.

SEC. 3. FAMILY ASTHMA CLINICAL AND ENVIRONMENTAL HEALTH RESEARCH 
              GRANTS.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the following:

``SEC. 399O. FAMILY ASTHMA CLINICAL AND ENVIRONMENTAL HEALTH RESEARCH 
              GRANT PROGRAM.

    ``(a) Purposes.--The purposes of this section are to provide 
authority to award grants to eligible entities serving a medically 
underserved population (as defined in section 330(b)(3)) for the 
conduct of pilot projects to prevent and control asthma symptoms and to 
reduce asthma attacks in families containing individuals with asthma 
through activities which may include--
            ``(1) researching and developing novel interventions to 
        reduce the burden of asthma, improve disease control, assist 
        with the management of asthma exacerbations by patients and 
        their families, and prevent asthma exacerbations;
            ``(2) utilizing the electronic medical record, telehealth, 
        and other novel electronic communications to prevent acute 
        asthma attacks;
            ``(3) facilitating communication of intervention and 
        prevention information to individuals with asthma and their 
        families and caregivers;
            ``(4) expanding the understanding of environmental and 
        other factors that cause and contribute to the burden of 
        asthma;
            ``(5) collecting and analyzing data in order to determine 
        the incidence, prevalence, and severity of asthma and 
        associated risk factors; and
            ``(6) expanding data collection of research into the 
        genetic susceptibility to asthma.
    ``(b) Authority To Make Grants.--
            ``(1) In general.--The Secretary, acting through the 
        Director of the National Institutes of Health, shall award 
        grants to eligible entities to carry out pilot projects 
        consistent with the activities described in subsection (a).
            ``(2) Awarding of grants.--In awarding the grants under 
        paragraph (1), the Secretary shall--
                    ``(A) give priority to entities that serve a 
                medically underserved population; and
                    ``(B) give consideration to an adequate rural-urban 
                distribution, so as to gain better information about 
                asthma at the national level.
            ``(3) Coordination of agencies.--The National Institute of 
        Environmental Health Sciences (which shall be the lead agency 
        for purposes of activities carried out under this section), in 
        coordination with the National Heart, Lung, and Blood 
        Institute, the National Institute of Allergy and Infectious 
        Diseases, and the National Institute of Child Health and Human 
        Development, shall administer grants to be utilized by entities 
        performing research of the type described in subsection (a). 
        Such Institutes shall coordinate in writing a Request for 
        Applications, reviewing applications, and providing 
        administrative oversight for the program carried out under this 
        section.
    ``(c) Eligibility.--To be eligible to receive a grant under 
subsection (b), an entity shall be--
            ``(1) a hospital, including children's hospitals;
            ``(2) a community health center;
            ``(3) a medical school;
            ``(4) a nonprofit institution; or
            ``(5) another entity, as designated by the Secretary.
    ``(d) Application.--
            ``(1) In general.--An eligible entity shall submit an 
        application to the Director of the National Institutes of 
        Health for a grant under this section at such time, in such 
        manner, and accompanied by such information as such Director 
        may require.
            ``(2) Required information.--An application submitted under 
        this subsection shall, to the extent practicable--
                    ``(A) include information demonstrating the 
                prevalence of chronic asthma among the population to be 
                served by the applicant on at least a State level basis 
                and where practicable, in areas and localities within 
                the State;
                    ``(B) provide assurance that the applicant will 
                establish consistent communication with patients using 
                the Internet or telephone for the prompt transmission 
                of patient information related to symptoms and 
                conditions, such as peak flow meter measurements;
                    ``(C) provide assurance that enrollees will have 
                baseline and ongoing medical data collected, including 
                data related to pulmonary function and skin or in vitro 
                testing for sensitization to allergies;
                    ``(D) propose novel approaches to studying the 
                gene-environment interaction of the patients and have 
                the capacity to engage in such data collection, or 
                partner with an institution with such a capacity;
                    ``(E) contain assurances that the applicant will 
                communicate in a manner designed to preserve patient 
                confidentiality, with at least 1 of the Asthma Clinical 
                Centers of the National Institutes of Health; and
                    ``(F) provide assurances that the entity can 
                effectively coordinate care between physicians, 
                including asthma specialists, nurses, allied health 
                professionals, community health workers, nonprofit 
                organizations, and the other entities responsible for 
                implementing the pilot project involved.
            ``(3) Collaboration with local institutions.--An eligible 
        entity under this section is encouraged to--
                    ``(A) collaborate with 1 or more Head Start 
                programs to identify children and families with asthma 
                within the geographic area of the applicant;
                    ``(B) collaborate with local school districts to 
                recruit children with physician-diagnosed asthma; and
                    ``(C) partner with local, community-based nonprofit 
                organizations to identify children and families with 
                asthma within the geographic area of the applicant.
    ``(e) Use of Funds.--
            ``(1) In general.--An eligible entity shall use amounts 
        received under a grant under this section to carry out the 
        purposes described in subsection (a), including--
                    ``(A) conducting an assessment of the patients 
                served to determine possible contributors to asthma 
                exacerbations in the indoor and outdoor environments, 
                including exposure to diesel and other particles, ozone 
                and other gases, gaseous pollutants and allergens, 
                mold, and other indoor pollutants;
                    ``(B) implementing interventions regarding indoor 
                and outdoor environments to reduce the severity and 
                persistence of asthma;
                    ``(C) developing and maintaining questionnaires 
                completed by the patients, or the parents or guardians 
                of the patients, regarding their respective occupations 
                and personal exposure history, in order to increase the 
                understanding of factors that contribute to asthma 
                prevalence; and
                    ``(D) conducting other research as designated by 
                the Director of the National Institutes of Health, 
                particularly in areas that will advance knowledge of 
                the factors that contribute to asthma.
            ``(2) Research of significant interest.--An eligible entity 
        is encouraged to conduct research under this section on the 
        interactions between environmental exposures and genetic 
        susceptibilities that contribute to the development or 
        exacerbation of asthma.
    ``(f) Protection of Information.--The Secretary shall ensure the 
protections of individual health privacy under this section consistent 
with the regulations promulgated under section 264(c) of the Health 
Insurance Portability and Accountability Act of 1996.
    ``(g) Authorization of Appropriations.--There are authorized to be 
appropriated $10,000,000 for each of fiscal years 2006 through 2010 to 
carry out this section.''.

SEC. 4. NATIONAL ASTHMA EDUCATION AND PREVENTION PROGRAM OF THE 
              NATIONAL HEART, LUNG, AND BLOOD INSTITUTE.

    Part C of title IV of the Public Health Service Act (42 U.S.C. 285 
et seq.) is amended by inserting after section 424B the following:

``SEC. 424C. EXPANSION OF THE NATIONAL ASTHMA EDUCATION AND PREVENTION 
              PROGRAM.

    ``(a) Development of a National Asthma Action Plan.--
            ``(1) In general.--In addition to any other authorization 
        of appropriation available to the National Heart, Lung, and 
        Blood Institute for the purpose of carrying out the National 
        Asthma Education and Prevention Program (referred to in this 
        section as the `Program'), there is authorized to be 
        appropriated to such Institute $1,000,000 for each of fiscal 
        years 2006 through 2010 to develop a National Asthma Action 
        Plan.
            ``(2) Use of appropriations.--The amount appropriated under 
        paragraph (1) shall be used to fund the report by the Program 
        described under subsection (b).
    ``(b) Report to Congress.--
            ``(1) In general.--Not later than 2 years after the date of 
        enactment of the Family Asthma Act, the Program shall, in 
        consultation with patient groups, nonprofit organizations, 
        medical societies, and other relevant governmental and 
        nongovernmental entities that participate in the Program, 
        submit to Congress a report that--
                    ``(A) catalogs, with respect to asthma prevention, 
                management, and surveillance--
                            ``(i) the activities of the Federal 
                        Government, including an assessment of the 
                        progress of the Federal Government and States, 
                        with respect to achieving the goals of the 
                        Healthy People 2010 initiative; and
                            ``(ii) the activities of other entities 
                        that participate in the Program, including 
                        nonprofit organizations, patient advocacy 
                        groups, and medical societies; and
                    ``(B) makes recommendations for the future 
                direction of asthma activities, in consultation with 
                researchers from the National Institutes of Health and 
                other member bodies of the National Asthma Education 
                and Prevention Program who are qualified to review and 
                analyze data and evaluate interventions, including--
                            ``(i) how the Federal Government may 
                        improve its response to asthma;
                            ``(ii) how the Federal Government may 
                        continue, expand, and improve its private-
                        public partnerships with respect to asthma;
                            ``(iii) steps that may be taken to reduce 
                        the--
                                    ``(I) morbidity, mortality, and 
                                overall prevalence of asthma;
                                    ``(II) financial burden of asthma 
                                on society;
                                    ``(III) burden of asthma on 
                                disproportionately affected areas, 
                                particularly those in medically 
                                underserved populations (as defined in 
                                section 330(b)(3)); and
                                    ``(IV) burden of asthma as a 
                                chronic disease;
                            ``(iv) identify programs that have achieved 
                        the steps described under clause (iii), and 
                        steps that may be taken to expand such programs 
                        to benefit larger populations; and
                            ``(v) recommendations for future research 
                        and interventions.
            ``(2) Updates to congress.--
                    ``(A) Congressional request.--During the 5-year 
                period following the submission of the report under 
                paragraph (1), the Program shall submit updates and 
                revisions of the report upon the request of Congress.
                    ``(B) Five-year reevaluation.--At the end of the 5-
                year period following the submission of the report 
                under paragraph (1), the Program shall evaluate its 
                analyses and recommendations under such report and 
                determine whether a new report to Congress is 
                necessary, and make appropriate recommendations to 
                Congress.''.

SEC. 5. ASTHMA-RELATED ACTIVITIES OF THE CENTERS FOR DISEASE CONTROL 
              AND PREVENTION.

    Section 317I of the Public Health Service Act (42 U.S.C. 247b-10) 
is amended to read as follows:

``SEC. 317I. ASTHMA-RELATED ACTIVITIES OF THE CENTERS FOR DISEASE 
              CONTROL AND PREVENTION.

    ``(a) Program for Providing Information and Education to the 
Public.--The Secretary, acting through the Director of the Centers for 
Disease Control and Prevention, shall collaborate with State and local 
health departments to conduct activities, including the provision of 
information and education to the public regarding asthma including--
            ``(1) deterring the harmful consequences of uncontrolled 
        asthma; and
            ``(2) disseminating health education and information 
        regarding prevention of asthma episodes and strategies for 
        managing asthma.
    ``(b) Compilation of Data.--The Secretary, acting through the 
Director of the Centers for Disease Control and Prevention, shall, in 
cooperation with State and local public health officials--
            ``(1) conduct asthma surveillance activities to collect 
        data on the prevalence and severity of asthma, the 
        effectiveness of public health asthma interventions, and the 
        quality of asthma management, including--
                    ``(A) collection of sample household data on the 
                local burden of asthma; and
                    ``(B) surveillance of sample health care 
                facilities; and
            ``(2) compile and annually publish data regarding--
                    ``(A) the prevalence and incidence of children 
                suffering with asthma in each State and, to the extent 
                practicable, at the county level;
                    ``(B) the childhood mortality rate associated with 
                asthma nationally and in each State and, to the extent 
                practicable, at the county level;
                    ``(C) the number of hospital admissions and 
                emergency department visits by children associated with 
                asthma nationally and in each State and, to the extent 
                practicable, at the county level; and
                    ``(D) the prevalence and incidence of adult asthma, 
                the adult mortality rate, and the number of hospital 
                admissions and emergency department visits by adults 
                associated with asthma nationally and in each State 
                and, to the extent practicable, at the county level.
    ``(c) Coordination of Data Collection.--The Director of the Centers 
for Disease Control and Prevention, in conjunction with State and local 
health departments, shall coordinate data collection activities under 
subsection (b)(2) so as to maximize comparability of results.
    ``(d) Collaboration.--
            ``(1) In general.--The Centers for Disease Control and 
        Prevention are encouraged to collaborate with national, State, 
        and local nonprofit organizations to provide information and 
        education about asthma, and to strengthen such collaborations 
        when possible.
            ``(2) Specific activities.--The Division of Adolescent and 
        School Health is encouraged to expand its activities with non-
        Federal partners, especially State-level entities.
    ``(e) Additional Funding.--In addition to any other authorization 
of appropriations that is available to the Centers for Disease Control 
and Prevention for the purpose of carrying out this section, there is 
authorized to be appropriated to such Centers $5,000,000 for each of 
fiscal years 2006 through 2010 for the purpose of carrying out this 
section.''.

SEC. 6. FELLOWSHIP TRAINING TO IMPROVE ASTHMA CARE.

    Part C of title IV of the Public Health Service Act (42 U.S.C. 285 
et seq.) is amended by inserting after section 463B the following:

``SEC. 463C. FELLOWSHIP TRAINING TO IMPROVE ASTHMA CARE.

    ``(a) Fellowship Training Program.--
            ``(1) In general.--The Director of the Institute shall 
        establish individual and institutional training grants for 
        education and training of healthcare providers, including 
        asthma specialists, researchers, and educators on the role of 
        environmental factors in the development and prevention of 
        asthma and recurrent asthma attacks, as well as methods to 
        reduce such factors, including knowledge of treatment as 
        recommended by the National Asthma Education and Prevention 
        Program guidelines.
            ``(2) Name of training grants.--The training grants awarded 
        under paragraph (1) shall be named in honor of Dr. Irving J. 
        Selikoff for his leadership in inaugurating the environmental 
        medicine movement.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated $2,000,000 for each of fiscal years 2005 through 2010 to 
carry out this section.''.
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