II 

111TH CONGRESS 

1ST SESSION S. 1577 

To provide the Secretary of Health and Human Services and the Secretary 

of Education with increased authority with respect to asthma programs, 

and to provide for increased funding for such programs. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 5, 2009 

Mrs. GILLIBRAND introduced the following bill; which was read twice and 

referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To provide the Secretary of Health and Human Services 

and the Secretary of Education with increased authority 

with respect to asthma programs, and to provide for 

increased funding for such programs. 

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 ‘‘Asthma Act’’. 

5 SEC. 2. FINDINGS. 

6 Congress finds as follows: 


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1 (1) Despite improved therapies, asthma affects 

2 approximately 22,000,000 adults and 6,800,000 

3 children under the age of 18 in the United States. 

4 (2) Approximately 1,000,000 hospital emer5 gency room visits are attributed to asthma annually. 

6 (3) Asthma can be life-threatening if not prop7 erly managed. Most asthma-related deaths are pre8 ventable, yet such deaths continue to occur in the 

9 United States. 

10 (4) Asthma-related health care costs are esti11 mated at $14,000,000,000 annually. 

12 (5) With early recognition of the signs and 

13 symptoms of asthma, proper diagnosis and treat14 ment, and patient education and self-management, 

15 asthma is a controllable disease. 

16 (6) Public health interventions have been prov17 en effective in the treatment and management of 

18 asthma. Population-based research supported by the 

19 National Institutes of Health has effectively dem20 onstrated the benefits of combining aggressive med21 ical treatment with patient education to improve the 

22 management of asthma. The National Asthma Edu23 cation and Prevention Program helps raise aware24 ness that asthma is a serious chronic disease, and 


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1 helps promote more effective management of asthma 

2 through patient and professional education. 

3 (7) The alarming rise in prevalence, asthma-re4 lated deaths, and expenditures demonstrate that, de5 spite extensive knowledge on effective asthma man6 agement strategies, current Federal policy and fund7 ing regarding the education, treatment, and manage8 ment of asthma is inadequate. 

9 (8) Additional Federal direction, funding, and 

10 support is necessary to increase awareness of asth11 ma as a chronic illness, its symptoms, and the envi12 ronmental factors (indoor and outdoor) that affect 

13 the disease, as well as to promote education pro14 grams that teach patients how to better manage 

15 asthma. 

16 SEC. 3. PROVISIONS REGARDING NATIONAL ASTHMA EDU17 CATION AND PREVENTION PROGRAM OF NA18 TIONAL HEART, LUNG, AND BLOOD INSTI19 TUTE. 

20 (a) ADDITIONAL FUNDING; EXPANSION OF PRO21 GRAM.—In addition to any other authorization of appro22 priations that is available to the National Heart, Lung, 

23 and Blood Institute for the purpose of carrying out the 

24 National Asthma Education and Prevention Program, 

25 there is authorized to be appropriated to such Institute 


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1 for such purpose $4,100,000 for each of the fiscal years 

2 2010 through 2014. Amounts appropriated under the pre3 ceding sentence shall be expended to expand such Pro4 gram. 

5 (b) COORDINATING COMMITTEE.— 

6 (1) REPORT TO CONGRESS.—With respect to 

7 the coordinating committee established for the Na8 tional Asthma Education and Prevention Program of 

9 the National Heart, Lung, and Blood Institute, such 

10 committee shall submit to Congress a report that— 

11 (A) contains a determination by the com12 mittee of the scope of the problem of asthma in 

13 the United States; 

14 (B) identifies all Federal programs that 

15 carry out asthma-related activities; and 

16 (C) contains the recommendations of the 

17 committee for strengthening and better coordi18 nating the asthma-related activities of the Fed19 eral Government. 

20 (2) INCLUSION OF REPRESENTATIVE OF DE21 PARTMENT OF EDUCATION.—The Secretary of Edu22 cation or a designee of such Secretary shall be in23 cluded in the membership of the coordinating com24 mittee described in paragraph (1). 


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1 SEC. 4. ASTHMA-RELATED ACTIVITIES OF CENTERS FOR 

2 DISEASE CONTROL AND PREVENTION. 

3 (a) EXPANSION OF PUBLIC HEALTH SURVEILLANCE

4 ACTIVITIES; PROGRAM FOR PROVIDING INFORMATION

5 AND EDUCATION TO PUBLIC.—The Secretary of Health 

6 and Human Services, acting through the Director of the 

7 Centers for Disease Control and Prevention, shall collabo8 rate with the States to expand the scope of— 

9 (1) activities that are carried out to determine 

10 the incidence and prevalence of asthma; and 

11 (2) activities that are carried out to prevent the 

12 health consequences of asthma, including through 

13 the provision of information and education to the 

14 public regarding asthma, which may include the use 

15 of public service announcements through the media 

16 and such other means as such Director determines 

17 to be appropriate. 

18 (b) COMPILATION OF DATA.—The Secretary of 

19 Health and Human Services, acting through the Director 

20 of the Centers for Disease Control and Prevention and in 

21 consultation with the National Asthma Education Preven22 tion Program Coordinating Committee, shall— 

23 (1) conduct local asthma surveillance activities 

24 to collect data on the prevalence and severity of 

25 asthma and the quality of asthma management, in26 cluding— 


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1 (A) telephone surveys to collect sample 

2 household data on the local burden of asthma; 

3 and 

4 (B) health care facility specific surveillance 

5 to collect asthma data on the prevalence and se6 verity of asthma, and on the quality of asthma 

7 care; and 

8 (2) compile and annually publish data on— 

9 (A) the prevalence of children suffering 

10 from asthma in each State; and 

11 (B) the childhood mortality rate associated 

12 with asthma nationally and in each State. 

13 (c) ADDITIONAL FUNDING.—In addition to any other 

14 authorization of appropriations that is available to the 

15 Centers for Disease Control and Prevention for the pur16 pose of carrying out this section, there is authorized to 

17 be appropriated to such Centers for such purpose 

18 $8,200,000 for each of the fiscal years 2010 through 

19 2014. 

20 SEC. 5. GRANTS FOR COMMUNITY OUTREACH REGARDING 

21 ASTHMA INFORMATION, EDUCATION, AND 

22 SERVICES. 

23 (a) IN GENERAL.—The Secretary of Health and 

24 Human Services (referred to in this section as the ‘‘Sec25 retary’’) may make grants to nonprofit private entities for 


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1 projects to carry out, in communities identified by entities 

2 applying for the grants, outreach activities to provide for 

3 residents of the communities the following: 

4 (1) Information and education on asthma. 

5 (2) Referrals to health programs of public and 

6 nonprofit private entities that provide asthma-re7 lated services, including such services for low-income 

8 individuals. The grant may be expended to make ar9 rangements to coordinate the activities of such enti10 ties in order to establish and operate networks or 

11 consortia regarding such referrals. 

12 (b) PREFERENCES IN MAKING GRANTS.—In making 

13 grants under subsection (a), the Secretary shall give pref14 erence to applicants that will carry out projects under such 

15 subsection in communities that are disproportionately af16 fected by asthma or underserved with respect to the activi17 ties described in such subsection and in which a significant 

18 number of low-income individuals reside. 

19 (c) EVALUATIONS.—As a condition for receiving a 

20 grant under subsection (a), the applicant for the grant 

21 shall agree to provide for the evaluation of the projects 

22 carried out under such subsection by the applicant to de23 termine the extent to which the projects have been effec24 tive in carrying out the activities described in such sub25 section. 


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1 (d) FUNDING.—For the purpose of carrying out this 

2 section, there is authorized to be appropriated $4,100,000 

3 for each of the fiscal years 2010 through 2014. 

4 SEC. 6. ACTION PLANS OF STATES REGARDING ASTHMA; FI5 NANCIAL INCENTIVES REGARDING CHIL6 DREN’S HEALTH INSURANCE PROGRAM. 

7 (a) IN GENERAL.—The Secretary of Health and 

8 Human Services (in this section referred to as the ‘‘Sec9 retary’’) shall in accordance with subsection (b) carry out 

10 a program to encourage the States to implement plans to 

11 carry out activities to assist children with respect to asth12 ma in accordance with guidelines of the National Heart, 

13 Lung, and Blood Institute. 

14 (b) RELATION TO CHILDREN’S HEALTH INSURANCE

15 PROGRAM.— 

16 (1) IN GENERAL.—Subject to paragraph (2), if 

17 a State plan under title XXI of the Social Security 

18 Act (42 U.S.C. 1397aa et seq.) provides for activi19 ties described in subsection (a) to an extent satisfac20 tory to the Secretary, the Secretary shall, with 

21 amounts appropriated under subsection (c), make a 

22 grant to the State involved to assist the State in car23 rying out such activities. 

24 (2) REQUIREMENT OF MATCHING FUNDS.— 


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1 (A) IN GENERAL.—With respect to the 

2 costs of the activities to be carried out by a 

3 State under paragraph (1), the Secretary may 

4 make a grant under such paragraph only if the 

5 State agrees to make available (directly or 

6 through donations from public or private enti7 ties) non-Federal contributions toward such 

8 costs in an amount that is not less than 50 per9 cent of the costs ($1 for each $1 of Federal 

10 funds provided in the grant). 

11 (B) DETERMINATION OF AMOUNT CON12 TRIBUTED.—Non-Federal contributions re13 quired in subparagraph (A) may be in cash or 

14 in kind, fairly evaluated, including plant, equip15 ment, or services. Amounts provided by the 

16 Federal Government, or services assisted or 

17 subsidized to any significant extent by the Fed18 eral Government, may not be included in deter19 mining the amount of such non-Federal con20 tributions. 

21 (3) CRITERIA REGARDING ELIGIBILITY FOR

22 GRANT.—The Secretary shall publish in the Federal 

23 Register criteria describing the circumstances in 

24 which the Secretary will consider a State plan to be 

25 satisfactory for purposes of paragraph (1). 


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1 (4) TECHNICAL ASSISTANCE.—With respect to 

2 State plans under title XXI of the Social Security 

3 Act, the Secretary, acting through the Director of 

4 the Centers for Disease Control and Prevention, 

5 shall make available to the States technical assist6 ance in developing the provisions of such plans that 

7 will provide for activities pursuant to paragraph (1). 

8 (c) FUNDING.—For the purpose of carrying out this 

9 section, there is authorized to be appropriated $4,100,000 

10 for each of the fiscal years 2010 through 2014. 

11 SEC. 7. ACTION PLANS OF LOCAL EDUCATIONAL AGENCIES 

12 REGARDING ASTHMA. 

13 (a) IN GENERAL.— 

14 (1) SCHOOL-BASED ASTHMA ACTIVITIES.—The 

15 Secretary of Education (in this section referred to as 

16 the ‘‘Secretary’’), in consultation with the Director 

17 of the Centers for Disease Control and Prevention 

18 and the Director of the National Institutes of 

19 Health, may make grants to local educational agen20 cies to carry out at elementary and secondary 

21 schools described in paragraph (2) programs for 

22 asthma-related activities for children who attend 

23 such schools. 

24 (2) ELIGIBLE SCHOOLS.—The elementary and 

25 secondary schools described in this paragraph are 


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1 such schools that are located in communities with a 

2 significant number of low-income or underserved in3 dividuals (as defined by the Secretary). 

4 (b) DEVELOPMENT OF PROGRAMS.—Programs under 

5 subsection (a) shall include grants under which local edu6 cation agencies and State public health officials collabo7 rate to develop programs to improve the management of 

8 asthma in school settings. 

9 (c) CERTAIN GUIDELINES.—Programs under sub10 section (a) shall be carried out in accordance with applica11 ble guidelines or other recommendations of the National 

12 Institutes of Health (including the National Heart, Lung, 

13 and Blood Institute) and the Environmental Protection 

14 Agency. 

15 (d) CERTAIN ACTIVITIES.—Activities that may be 

16 carried out in programs under subsection (a) include the 

17 following: 

18 (1) Identifying and working directly with local 

19 hospitals, community clinics, advocacy organizations, 

20 parent-teacher associations, and asthma coalitions. 

21 (2) Identifying asthmatic children and training 

22 such children and the families of such children in 

23 asthma self-management. 

24 (3) Purchasing asthma equipment. 

25 (4) Hiring school nurses. 


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1 (5) Training teachers, nurses, coaches, and 

2 other school personnel in asthma-symptom recogni3 tion and emergency responses. 

4 (6) Simplifying procedures to improve safe ac5 cess of students to asthma medications. 

6 (7) Such other asthma-related activities as the 

7 Secretary determines to be appropriate. 

8 (e) DEFINITIONS.—For purposes of this section, the 

9 terms ‘‘elementary school’’, ‘‘local educational agency’’, 

10 and ‘‘secondary school’’ have the meanings given such 

11 terms in section 9101 of the Elementary and Secondary 

12 Education Act of 1965 (20 U.S.C. 7801). 

13 (f) FUNDING.—For the purpose of carrying out this 

14 section, there is authorized to be appropriated $4,100,000 

15 for each of the fiscal years 2010 through 2014. 

16 SEC. 8. SENSE OF CONGRESS REGARDING HOSPITALS AND 

17 MANAGED CARE PLANS. 

18 It is the sense of Congress that— 

19 (1) hospitals should be encouraged to offer 

20 asthma-related education and training to asthma pa21 tients and families of asthma patients upon dis22 charge from the hospital of such patients; 

23 (2) hospitals should, with respect to information 

24 on asthma, establish telephone services for patients 


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1 and communicate with providers of primary health 

2 services; and 

3 (3) managed care organizations should— 

4 (A) be encouraged to disseminate to health 

5 care providers asthma clinical practice guide6 lines developed or endorsed by the Public 

7 Health Service; 

8 (B) collect and maintain asthma data; and 

9 (C) offer asthma-related education and 

10 training to asthma patients and their families. 

11 SEC. 9. SENSE OF CONGRESS REGARDING IMPLEMENTA12 TION OF ACT. 

13 It is the sense of Congress that all Federal, State, 

14 and local asthma-related activities should— 

15 (1) promote the guidelines and other rec16 ommendations of the Public Health Service on asth17 ma diagnosis and management; and 

18 (2) be designed in consultation with national 

19 and local organizations representing the medical, 

20 educational, and environmental communities, as well 

21 as advocates that represent those affected by asth22 ma. 

Æ 


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