1.This Act may be cited as the
Family Asthma
Act
.
2.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.
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—
(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:
399U.Family asthma
clinical and environmental health research grant program
(a)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)
(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 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)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)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)
(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 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 institutionsAn 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)
(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, 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 interestAn 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
informationThe 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)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
appropriationsThere are authorized to be appropriated such sums
as may be necessary for each of fiscal years 2010 through 2014 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 424C the following:
424D.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 such sums as may be necessary for each of fiscal
years 2010 through 2014 to develop a National Asthma Action Plan.
(2)The amounts appropriated pursuant to 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 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)
(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 the 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 the Congress is necessary, and make appropriate recommendations to
the
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)Development of
state asthma plansThe 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)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 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 (c)(2) so as to maximize
comparability of results.
(e)
(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.
(f)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.
.