[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3904 Introduced in House (IH)]
110th CONGRESS
1st Session
H. R. 3904
To amend the Public Health Service Act with regard to research on
asthma, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 18, 2007
Mrs. McCarthy of New York introduced the following bill; which was
referred to the Committee on Energy and Commerce
_______________________________________________________________________
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
since 1985. According to the Centers for Disease Control and
Prevention, in 2005, more than 30,000,000 Americans had been
diagnosed with asthma, including an estimated 9,200,000
children. Asthma rates are highest among Puerto Rican
populations, who are 95 percent more likely to have been
diagnosed with asthma that White populations. 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 2004, more than 3,000 Americans died from
asthma. Mortality from asthma is higher among African-Americans
and women.
(3) The Centers for Disease Control and Prevention reports
that asthma accounts for nearly 500,000 hospitalizations each
year, and approximately 1,800,000 asthma-related visits to
hospital emergency departments occur each year. Studies have
shown the emergency department visit rate for Blacks seeking
asthma treatment was 350 percent higher than that of the rates
for Whites, while the hospitalization rate for Blacks with
asthma was 240 percent higher than that for Whites with asthma.
(4) 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.
(5) 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, almost
13,000,000 school and 10,000,000 work days are missed annually
as a result of asthma.
(6) 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.
(7) 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.
(8) 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. 399R. FAMILY ASTHMA CLINICAL AND ENVIRONMENTAL HEALTH RESEARCH
GRANT PROGRAM.
``(a) Purpose.--The purpose of this section is to provide authority
to award grants to eligible entities serving a medically underserved
population (as defined in section 330(b)(3)) to carry out pilot
projects to prevent and control asthma symptoms and to reduce asthma
attacks and improve patient self-management for individuals and 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 electronic medical records, 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, as is applicable and practicable to the
area and scope of the pilot project--
``(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,
including 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
purpose 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 2008 through 2012 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 2008 through 2012 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 $10,000,000 for each of
fiscal years 2008 through 2012 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 2008 through 2012 to
carry out this section.''.
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