I 

116TH CONGRESS 

1ST SESSION H. R. 5230 

To amend the Public Health Service Act with regard to research on asthma, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 21, 2019 

Mr. ENGEL (for himself, Mr. UPTON, Mr. COX of California, and Mr. KING

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Elijah E. Cummings 

5 Family Asthma Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) According to the Centers for Disease Con9 trol and Prevention, in 2017 more than 25,100,000 


kjohnson on DSK79L0C42 with BILLS
2 

•HR 5230 IH

1 people in the United States had been diagnosed with 

2 asthma, including an estimated 6,200,000 children. 

3 (2) According to the Centers for Disease Con4 trol and Prevention, asthma usually affects racial 

5 and ethnic minorities, including African Americans, 

6 American Indians, Alaska Natives, Puerto Ricans, 

7 and people of multiple races more than non-Hispanic 

8 Whites. In 2017, Puerto Ricans and African Ameri9 cans had the highest lifetime prevalence of asthma 

10 at 20.6 and 15.2 percent, respectively. 

11 (3) According to the Centers for Disease Con12 trol and Prevention, among children, males have 

13 higher rates of asthma than females, and in adults 

14 women have higher rates of asthma than men. Indi15 viduals living below the poverty threshold also had 

16 significantly higher rates of asthma in 2017 than in17 dividuals living above the poverty threshold. 

18 (4) According to the Centers for Disease Con19 trol and Prevention, in 2017 more than 3,500 people 

20 in the United States died from asthma. The rate of 

21 mortality from asthma is higher among African 

22 Americans and women. 

23 (5) The Centers for Disease Control and Pre24 vention report that asthma accounted for approxiVerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230

kjohnson on DSK79L0C42 with BILLS
3 

•HR 5230 IH

1 mately 180,000 hospitalizations and 1,800,000 visits 

2 to hospital emergency departments in 2016. 

3 (6) According to the Centers for Disease Con4 trol and Prevention, the annual cost of asthma to 

5 the United States is approximately 

6 $81,900,000,000, including $3,000,000,000 in indi7 rect costs from missed days of school and work. 

8 (7) According to the Centers for Disease Con9 trol and Prevention, 5,200,000 school days and 

10 8,500,000 work days are missed annually as a result 

11 of asthma. 

12 (8) Asthma episodes can be triggered by both 

13 outdoor air pollution and indoor air pollution, in14 cluding pollutants such as cigarette smoke and com15 bustion by-products. Asthma episodes can also be 

16 triggered by indoor allergens such as animal dander 

17 and outdoor allergens such as pollen and molds. 

18 (9) Public health interventions and medical care 

19 in accordance with existing guidelines have been 

20 proven effective in the treatment and management 

21 of asthma. Better asthma management could reduce 

22 the numbers of emergency department visits and 

23 hospitalizations due to asthma. Studies published in 

24 medical journals, including the Journal of Asthma 

25 and The Journal of Pediatrics, have shown that betVerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230

kjohnson on DSK79L0C42 with BILLS
4 

•HR 5230 IH

1 ter asthma management results in improved asthma 

2 outcomes at a lower cost. 

3 (10) In 2016, the Centers for Disease Control 

4 and Prevention reported that less than half of people 

5 with asthma reported receiving self-management 

6 training for their asthma. More education about 

7 triggers, proper treatment, and asthma management 

8 methods is needed. 

9 (11) The alarming rise in the prevalence of 

10 asthma, its adverse effect on school attendance and 

11 productivity, and its cost for hospitalizations and 

12 emergency room visits, highlight the importance of 

13 public health interventions, including increasing 

14 awareness of asthma as a chronic illness, its symp15 toms, the role of both indoor and outdoor environ16 mental factors that exacerbate the disease, and other 

17 factors that affect its exacerbations and severity. 

18 The goals of the Federal Government and its part19 ners in the nonprofit and private sectors should in20 clude reducing the number and severity of asthma 

21 attacks, asthma’s financial burden, and the health 

22 disparities associated with asthma. 

23 (12) The high health and financial burden 

24 caused by asthma underscores the importance of ad25 herence to the National Asthma Education and PreVerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230

kjohnson on DSK79L0C42 with BILLS
5 

•HR 5230 IH

1 vention Guidelines of the National Heart, Lung, and 

2 Blood Institute. Increasing adherence to guidelines3 based care and resulting patient management prac4 tices will enhance the quality of life for patients with 

5 asthma and decrease asthma-related morbidity and 

6 mortality. 

7 SEC. 3. ASTHMA-RELATED ACTIVITIES OF THE CENTERS 

8 FOR DISEASE CONTROL AND PREVENTION. 

9 Section 317I of the Public Health Service Act (42 

10 U.S.C. 247b–10) is amended to read as follows: 

11 ‘‘SEC. 317I. ASTHMA-RELATED ACTIVITIES OF THE CENTERS 

12 FOR DISEASE CONTROL AND PREVENTION. 

13 ‘‘(a) PROGRAM FOR PROVIDING INFORMATION AND

14 EDUCATION TO THE PUBLIC.—The Secretary, acting 

15 through the Director of the Centers for Disease Control 

16 and Prevention and the National Center for Environ17 mental Health, shall collaborate with State and local 

18 health departments to conduct activities, including the 

19 provision of information and education to the public re20 garding asthma including— 

21 ‘‘(1) deterring the harmful consequences of un22 controlled asthma; and 

23 ‘‘(2) disseminating health education and infor24 mation regarding prevention of asthma episodes and 

25 strategies for managing asthma. 


kjohnson on DSK79L0C42 with BILLS
6 

•HR 5230 IH

1 ‘‘(b) DEVELOPMENT OF STATE STRATEGIC PLANS

2 FOR ASTHMA CONTROL.—The Secretary, acting through 

3 the Director of the Centers for Disease Control and Pre4 vention, shall collaborate with State and local health de5 partments to develop State strategic plans for asthma con6 trol incorporating public health responses to reduce the 

7 burden of asthma, particularly regarding disproportion8 ately affected populations. 

9 ‘‘(c) COMPILATION OF DATA.—The Secretary, acting 

10 through the Director of the Centers for Disease Control 

11 and Prevention, shall, in cooperation with State and local 

12 public health officials— 

13 ‘‘(1) conduct asthma surveillance activities to 

14 collect data on the prevalence and severity of asth15 ma, the effectiveness of public health asthma inter16 ventions, and the quality of asthma management, in17 cluding— 

18 ‘‘(A) collection of data on or among people 

19 with asthma to monitor the impact on health 

20 and quality of life; 

21 ‘‘(B) surveillance of health care facilities; 

22 and 

23 ‘‘(C) collection of data not containing indi24 vidually identifiable information from electronic 


kjohnson on DSK79L0C42 with BILLS
7 

•HR 5230 IH

1 health records or other electronic communica2 tions; 

3 ‘‘(2) compile and annually publish data regard4 ing the prevalence of childhood asthma, the child 

5 mortality rate, and the number of hospital admis6 sions and emergency department visits by children 

7 associated with asthma nationally and in each State 

8 by age, sex, race, and ethnicity, as well as lifetime 

9 and current prevalence; and 

10 ‘‘(3) compile and annually publish data regard11 ing the prevalence of adult asthma, the adult mor12 tality rate, and the number of hospital admissions 

13 and emergency department visits by adults associ14 ated with asthma nationally and in each State by 

15 age, sex, race, and ethnicity, as well as lifetime and 

16 current prevalence. 

17 ‘‘(d) COORDINATION OF DATA COLLECTION.—The 

18 Director of the Centers for Disease Control and Preven19 tion, in conjunction with State and local health depart20 ments, shall coordinate data collection activities under 

21 subsection (c)(2) so as to maximize the comparability of 

22 results. 

23 ‘‘(e) COLLABORATION.— 

24 ‘‘(1) IN GENERAL.—The Centers for Disease 

25 Control and Prevention are encouraged to collaboVerDate Sep 11 2014 03:08 Dec 04, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5230.IH H5230

kjohnson on DSK79L0C42 with BILLS
8 

•HR 5230 IH

1 rate with national, State, and local nonprofit organi2 zations to provide information and education about 

3 asthma, and to strengthen such collaborations when 

4 possible. 

5 ‘‘(2) SPECIFIC ACTIVITIES.—The Division of 

6 Population Health is encouraged to expand its ac7 tivities with non-Federal partners, especially State8 level entities. 

9 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

10 carry out this section, there are authorized to be appro11 priated $65,000,000 for the period of fiscal years 2021 

12 through 2025. 

13 ‘‘(g) REPORTS TO CONGRESS.— 

14 ‘‘(1) IN GENERAL.—Not later than 3 years 

15 after the date of enactment of this Act, and once 2 

16 years thereafter, the Secretary shall, in consultation 

17 with patient groups, nonprofit organizations, medical 

18 societies, and other relevant governmental and non19 governmental entities, submit to Congress a report 

20 that— 

21 ‘‘(A) catalogs, with respect to asthma pre22 vention, management, and surveillance— 

23 ‘‘(i) the activities of the Federal Gov24 ernment, including an assessment of the 

25 progress of the Federal Government and 


kjohnson on DSK79L0C42 with BILLS
9 

•HR 5230 IH

1 States, with respect to achieving the goals 

2 of the Healthy People 2030 initiative; and 

3 ‘‘(ii) the activities of other entities 

4 that participate in the program under this 

5 section, including nonprofit organizations, 

6 patient advocacy groups, and medical soci7 eties; and 

8 ‘‘(B) makes recommendations for the fu9 ture direction of asthma activities, in consulta10 tion with researchers from the National Insti11 tutes of Health and other member bodies of the 

12 Asthma Disparities Subcommittee, including— 

13 ‘‘(i) a description of how the Federal 

14 Government may improve its response to 

15 asthma, including identifying any barriers 

16 that may exist; 

17 ‘‘(ii) a description of how the Federal 

18 Government may continue, expand, and 

19 improve its private-public partnerships 

20 with respect to asthma, including identi21 fying any barriers that may exist; 

22 ‘‘(iii) the identification of steps that 

23 may be taken to reduce the— 

24 ‘‘(I) morbidity, mortality, and 

25 overall prevalence of asthma; 


kjohnson on DSK79L0C42 with BILLS
10 

•HR 5230 IH

1 ‘‘(II) financial burden of asthma 

2 on society; 

3 ‘‘(III) burden of asthma on dis4 proportionately affected areas, par5 ticularly those in medically under6 served populations (as defined in sec7 tion 330(b)(3)); and 

8 ‘‘(IV) burden of asthma as a 

9 chronic disease that can be worsened 

10 by environmental exposures; 

11 ‘‘(iv) the identification of programs 

12 and policies that have achieved the steps 

13 described under clause (iii), and steps that 

14 may be taken to expand such programs 

15 and policies to benefit larger populations; 

16 and 

17 ‘‘(v) recommendations for future re18 search and interventions. 

19 ‘‘(2) SUBSEQUENT REPORTS.— 

20 ‘‘(A) CONGRESSIONAL REQUEST.—During 

21 the 5-year period following the submission of 

22 the second report under paragraph (1), the Sec23 retary shall submit updates and revisions of the 

24 report upon the request of the Congress. 


kjohnson on DSK79L0C42 with BILLS
11 

•HR 5230 IH

1 ‘‘(B) FIVE-YEAR REEVALUATION.—At the 

2 end of the 5-year period referred to in subpara3 graph (A), the Secretary shall— 

4 ‘‘(i) evaluate the analyses and rec5 ommendations made in previous reports; 

6 and 

7 ‘‘(ii) determine whether an additional 

8 updated report is needed and if so submit 

9 such an additional updated report to the 

10 Congress, including appropriate recommen11 dations.’’. 

Æ 


kjohnson on DSK79L0C42 with BILLS