[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3754 Introduced in House (IH)]
111th CONGRESS
1st Session
H. R. 3754
To amend the Public Health Service Act with regard to research on
asthma, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 7, 2009
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.
The Congress makes the following findings:
(1) The number of people with asthma more than doubled
between 1980 and 1995. According to the Centers for Disease
Control and Prevention, in 2007 more than 34,000,000 Americans
had been diagnosed with asthma, including an estimated
9,600,000 children. Asthma rates are highest among Puerto Rican
populations. Rates were 140 percent greater among Puerto Rican
children compared to non-Hispanic White children. Asthma
strikes 1 in 13 Americans.
(2) According to the Centers for Disease Control and
Prevention, in 2005 more than 3,800 Americans died from asthma.
The rate of mortality from asthma is higher among African-
Americans and women.
(3) The Centers for Disease Control and Prevention report
that asthma accounted for more than 440,000 hospitalizations
and more than 1,600,000 visits to hospital emergency
departments in 2006. The rate for asthma-related emergency room
visits is 500 percent greater and hospitalization rates are 300
percent higher for Blacks compared to Whites.
(4) According to the National Heart, Lung, and Blood
Institute of the National Institutes of Health, the annual cost
of asthma to the United States is approximately
$19,700,000,000.
(5) According to the Centers for Disease Control and
Prevention, almost 13,000,000 school days 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-products. 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 better asthma management
results in improved asthma outcomes at a lower cost.
(8) In 2005, the Centers for Disease Control and Prevention
cited ``the urgent need'' for enhanced public health
surveillance data regarding asthma, noting that the current
system has led to a ``patchwork of health effect measures''.
National data are needed to allow comparisons at smaller
geographic levels, such as counties, and to better understand
the groups at risk.
(9) The alarming rise in the prevalence of asthma, its
adverse effect on school attendance and productivity, and its
cost 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, asthma's
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--
(1) by redesignating the second and third sections 399R
(added by Public Laws 110-373 and 110-374, respectively) as
sections 399S and 399T; and
(2) by adding at the end the following:
``SEC. 399U. FAMILY ASTHMA CLINICAL AND ENVIRONMENTAL HEALTH RESEARCH
GRANT PROGRAM.
``(a) Purpose.--The purpose of this section is to authorize the
National Institutes of Health to award grants 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 including--
``(1) utilizing electronic health records, telehealth, and
other novel electronic communications to prevent acute asthma
attacks, and to improve asthma surveillance activities as
described under section 317I(c); and
``(2) expanding the understanding of environmental and
other factors that cause and contribute to the burden of
asthma.
``(b) 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
disproportionately impacted populations; and
``(B) give consideration to an adequate national
understanding of asthma prevalence, so as to gain
better information about asthma at the national level.
``(3) Coordination of agencies.--The National Heart, Lung,
and Blood Institute (which shall be the lead agency for
purposes of activities carried out under this section), in
coordination with the National Institute of Environmental
Health Sciences, 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 a children's hospital;
``(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 flowmeter
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 applicant 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 receiving a grant 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 entity.
``(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, chemicals found in the home or workplace, 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
receiving a grant under this section 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
implementation of 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) Report.--The Secretary shall submit a report to the Congress
on the success of and the next steps resulting from the pilot projects
funded under this section not later than 5 years after the date of the
enactment of this section.
``(h) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary for each of fiscal years
2010 through 2014 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 424C the following:
``SEC. 424D. 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 such sums as may be necessary
for each of fiscal years 2010 through 2014 to develop a
National Asthma Action Plan.
``(2) Use of appropriations.--The amounts appropriated
pursuant to 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
the 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 the 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 2020 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) description of how the Federal
Government may improve its response to asthma
including identifying any barriers that may
exist;
``(ii) description of how the Federal
Government may continue, expand, and improve
its private-public partnerships with respect to
asthma including identifying any barriers that
may exist;
``(iii) identification of 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) identification of programs and
policies that have achieved the steps described
under clause (iii), and steps that may be taken
to expand such programs and policies 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 the
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 the Congress is
necessary, and make appropriate recommendations to the
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) Development of State Asthma Plans.--The Secretary, acting
through the Director of the Centers for Disease Control and Prevention,
shall collaborate with State and local health departments to develop
State plans incorporating public health responses to reduce the burden
of asthma, particularly regarding disproportionately affected
populations.
``(c) 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 household data on the local
burden of asthma;
``(B) surveillance of health care facilities; and
``(C) collection of data not containing
individually identifiable information from electronic
health records or other electronic communications;
``(2) compile and annually publish data regarding the
prevalence and incidence of childhood asthma, the child
mortality rate, and the number of hospital admissions and
emergency department visits by children associated with asthma
nationally and in each State and at the county level by age,
sex, race, and ethnicity, as well as lifetime and current
prevalence; and
``(3) compile and annually publish data regarding 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 at the county level by age, sex, race,
ethnicity, industry, and occupation, as well as lifetime and
current prevalence.
``(d) 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 (c)(2) so as to maximize comparability of results.
``(e) 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.
``(f) 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 such sums as may be
necessary for each of fiscal years 2010 through 2014 for the purpose of
carrying out this section.''.
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