[Congressional Record Volume 149, Number 66 (Tuesday, May 6, 2003)]
[Senate]
[Pages S5786-S5787]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN (for himself, Ms. Collins, and Mrs. Clinton):
  S. 1004. A bill to ensure that children at highest risk for asthma, 
vision, hearing, and other health problems are identified and treated; 
to the Committee on Finance.
  Mr. DURBIN. Mr. President, I rise today to introduce the Healthy 
Children Learn Act with my colleague from Maine, Senator Collins. I am 
also pleased to have Senator Clinton as an original cosponsor of this 
measure. This legislation focuses on eliminating some bureaucratic 
barriers that make it more difficult for schools to provide their 
students with health care services, if they so choose.
  Many schools have found that the health of a child can significantly 
affect his or her ability to learn. To enhance children's learning 
ability and to increase the well-being of their students, these schools 
sometimes choose to provide health care services including health care 
screenings.
  One example of a disease that significantly affects children's 
education is asthma. Asthma is the single greatest reason for school 
absenteeism today. Over five million children in America suffer from 
asthma. Forty-nine percent of children with asthma missed school in the 
last year, and 48 percent of children with asthma are limited in sports 
and recreation. Lack of physical activity, in turn, can lead to 
childhood obesity with its concomitant health care problems.
  ``America is in the middle of an asthma epidemic--an epidemic that is 
getting worse, not better.'' So says the PEW Environmental Health 
Commission in its most recent report on asthma. The prevalence of 
asthma continues to rise at astounding rates, in every region of the 
country and across all demographic groups, whether measured by age, 
race or sex.
  My home State of Illinois has some of the highest rates of childhood 
asthma in the country. Unfortunately, Chicago has the highest childhood 
asthma-related death rate in the Nation. Over 60 percent of childhood 
admissions to the emergency room in Chicago are for asthma. This 
disease exacts a very significant toll on children in my State.
  For the next 15 minutes, imagine breathing through a tiny straw the 
size of a coffee stirrer, never getting enough air. Now imagine 
suffering through the process three to six times a day. This is asthma. 
Can a child really concentrate on learning when he or she is gasping 
for air?
  Due to the very high rates of asthma in Chicago and its effects on 
absenteeism and children's ability to learn

[[Page S5787]]

when at school, the Chicago Public Schools, CPS, instituted an asthma 
screening program. The school system developed an asthma manual to 
provide a standard plan of care for all students with asthma. They 
provided citywide nurse training to develop a uniform, high standard 
for approaching students with asthma and their parents and high-quality 
education about the environmental triggers for asthma and how to lessen 
them, together with education on how to use asthma inhalers. In 1999, 
they identified 12,374 cases of asthma. CPS continues to monitor and 
evaluate this program, and they have also partnered with other 
organizations such as the American Red Cross Asthma Program, the 
University of Chicago and the Chicago Department of Public Health 
Asthma Programs. CPS has also developed parent tutoring programs and 
has linked asthmatic children with primary health care providers for 
appropriate follow-up.
  All of these efforts are extremely important, but they are resource 
intensive. This legislation addresses a barrier to children receiving 
vital health screenings in schools. It provides for a $10 million grant 
program for school districts such as CPS to apply for funds for asthma 
screening for those children who are not eligible for either S-CHIP or 
Medicaid. The grants would be targeted to those districts that have the 
highest prevalence or deaths associated with asthma.
  CPS has also found that a child's ability to learn is affected by 
impaired vision and hearing, and as a result, children with vision 
deficits are far more likely to fail academically. In 1998, CPS found 
that children who were retained failed their school-based vision 
screening at a rate 50 percent higher than children who were not 
failing. Likewise, children who have difficulty hearing often struggle 
with language development, social processes and communication. This can 
seriously impair all aspects of the educational process. Through these 
programs, CPS has provided more than 5,000 free eye exams, and 4,000 
free pairs of glasses have been dispensed. They currently are 
reimbursed less than 40 percent of the cost of the vision and hearing 
screenings. To address some of these funding shortfalls, this 
legislation creates a $10 million grant program for vision and hearing 
screening.
  This legislation would also remove barriers that prevent school 
systems from receiving reimbursement for health screenings are 
services. Schools that make the extra effort to provide their students 
health care services should be adequately reimbursed. For an example, 
when they provide Medicaid-eligible children with Medicaid-covered 
services, they should receive appropriate reimbursement for those 
services. Likewise, reimbursement for the S-CHIP program should be 
available for covered services for children enrolled or eligible for 
the program. and clarifies Medicaid payment rules so that schools can 
be reimbursed when they provide a Medicaid covered service to a 
Medicaid child.
  No child should have his or her education threatened by the lack of 
effective screening to diagnose these health problems. The treatments 
or corrective devices are available and we should see to it that the 
children receive them when necessary. The Healthy Children Learn Act 
will help children receive the health care services they need so that 
they can seize the educational opportunities available to them.
                                 ______