1.This Act may be cited as the
Family Asthma
Act
.
2.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 than 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.
3.Family asthma clinical
and environmental health research grantsPart 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:
399R.Family asthma
clinical and environmental health research grant program
(a)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)
(1)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)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)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)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)
(1)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)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 institutionsAn
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)
(1)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 interestAn
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
informationThe 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 appropriationsThere are
authorized to be appropriated $10,000,000 for each of fiscal years 2008 through
2012 to carry out this
section.
.
4.National asthma
education and prevention program of the national heart, lung, and blood
institutePart 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:
424C.Expansion of the
national asthma education and prevention program
(a)Development of
a national asthma action plan
(1)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)The amount
appropriated under paragraph (1) shall be used to fund the report by the
Program described under subsection (b).
(b)
(1)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)
(A)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)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.
.
5.Asthma–related
activities of the centers for disease control and preventionSection 317I of the Public Health Service
Act (42 U.S.C. 247b–10) is amended to read as follows:
317I.Asthma-related
activities of the centers for disease control and prevention
(a)Program for
providing information and education to the publicThe 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)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 collectionThe 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)
(1)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)The Division of
Adolescent and School Health is encouraged to expand its activities with
non-Federal partners, especially State-level entities.
(e)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.
.
6.Fellowship training to
improve asthma carePart 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:
463C.Fellowship training
to improve asthma care
(a)Fellowship
training program
(1)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)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 appropriationsThere are
authorized to be appropriated $2,000,000 for each of fiscal years 2008 through
2012 to carry out this
section.
.