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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1760 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                S. 1760

   To amend the Public Health Service Act with regard to research on 
                    asthma, and for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            October 7, 2009

    Mr. Lautenberg (for himself and Mrs. Gillibrand) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 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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