I 

109TH CONGRESS 

1ST SESSION H. R. 2098 

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 HOUSE OF REPRESENTATIVES 

MAY 4, 2005 

Mrs. LOWEY introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on 

Education and the Workforce, for a period to be subsequently determined 

by the Speaker, in each case for consideration of such provisions as fall 

within the jurisdiction of the committee concerned 

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 The Congress finds as follows: 
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1 (1) Despite improved therapies, asthma cur2 rently affects 21.9 million Americans adults and 8.9 

3 million children under the age of 18. 

4 (2) There were 1.9 million asthma-related visits 

5 to hospital emergency departments in 2002, includ6 ing 727,000 for children under 18. 

7 (3) Asthma can be life-threatening if not prop8 erly managed. Most asthma-related deaths are pre9 ventable, yet such deaths continue to rise in the U.S. 

10 Each day, 14 Americans die of asthma. 

11 (4) Asthma-related health care costs are esti12 mated at $14 billion annually. 

13 (5) With early recognition of the signs and 

14 symptoms of asthma, proper diagnosis and treat15 ment, and patient education and self-management, 

16 asthma is a controllable disease. 

17 (6) Public health interventions have been prov18 en effective in the treatment and management of 

19 asthma. Population-based research supported by the 

20 National Institutes of Health (NIH) has effectively 

21 demonstrated the benefits of combining aggressive 

22 medical treatment with patient education to improve 

23 the management of asthma. The National Asthma 

24 Education and Prevention Program (NAEPP) helps 

25 raise awareness that asthma is a serious chronic dis-
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1 ease, and helps promote more effective management 

2 of asthma through patient and professional edu3 cation. 

4 (7) The alarming rise in prevalence, asthma-re5 lated deaths, and expenditures demonstrate that, de6 spite extensive knowledge on effective asthma man7 agement strategies, current federal policy and fund8 ing regarding the education, treatment, and manage9 ment of asthma is inadequate. 

10 (8) Additional Federal direction, funding, and 

11 support is necessary to increase awareness of asth12 ma as a chronic illness, its symptoms, and the envi13 ronmental factors (indoor and outdoor) that affect 

14 the disease, as well as to promote education pro15 grams that teach patients how to better manage 

16 asthma. 

17 SEC. 3. PROVISIONS REGARDING NATIONAL ASTHMA EDU18 CATION AND PREVENTION PROGRAM OF NA19 TIONAL HEART, LUNG, AND BLOOD INSTI20 TUTE. 

21 (a) ADDITIONAL FUNDING; EXPANSION OF PRO22 GRAM.—In addition to any other authorization of appro23 priations that is available to the National Heart, Lung, 

24 and Blood Institute for the purpose of carrying out the 

25 National Asthma Education and Prevention Program, 
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1 there is authorized to be appropriated to such Institute 

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

3 2006 through 2010. Amounts appropriated under the pre4 ceding sentence shall be expended to expand such Pro5 gram. 

6 (b) COORDINATING COMMITTEE.— 

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

8 the coordinating committee established for the Na9 tional Asthma Education and Prevention Program of 

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

11 committee shall submit to the Congress a report 

12 that— 

13 (A) contains a determination by the com14 mittee of the scope of the problem of asthma in 

15 the United States; 

16 (B) identifies all Federal programs that 

17 carry out asthma-related activities; and 

18 (C) contains the recommendations of the 

19 committee for strengthening and better coordi20 nating the asthma-related activities of the Fed21 eral Government. 

22 (2) INCLUSION OF REPRESENTATIVE OF DE23 PARTMENT OF EDUCATION.—The Secretary of Edu24 cation or a designee of the Secretary shall be in-
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1 cluded in the membership of the coordinating com2 mittee referred to in paragraph (1). 

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

4 DISEASE CONTROL AND PREVENTION. 

5 (a) EXPANSION OF PUBLIC HEALTH SURVEILLANCE

6 ACTIVITIES; PROGRAM FOR PROVIDING INFORMATION

7 AND EDUCATION TO PUBLIC.—The Secretary of Health 

8 and Human Services, acting through the Director of the 

9 Centers for Disease Control and Prevention, shall collabo10 rate with the States to expand the scope of— 

11 (1) activities that are carried out to determine 

12 the incidence and prevalence of asthma; and 

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

14 health consequences of asthma, including through 

15 the provision of information and education to the 

16 public regarding asthma, which may include the use 

17 of public service announcements through the media 

18 and such other means as such Director determines 

19 to be appropriate. 

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

21 Health and Human Services, acting through the Director 

22 of the Centers for Disease Control and Prevention and in 

23 consultation with the National Asthma Education Preven24 tion Program Coordinating Committee, shall— 
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1 (1) conduct local asthma surveillance activities 

2 to collect data on the prevalence and severity of 

3 asthma and the quality of asthma management, in4 cluding— 

5 (A) telephone surveys to collect sample 

6 household data on the local burden of asthma; 

7 and 

8 (B) health care facility specific surveillance 

9 to collect asthma data on the prevalence and se10 verity of asthma, and on the quality of asthma 

11 care; and 

12 (2) compile and annually publish data on— 

13 (A) the prevalence of children suffering 

14 from asthma in each State; and 

15 (B) the childhood mortality rate associated 

16 with asthma nationally and in each State. 

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

18 authorization of appropriations that is available to the 

19 Centers for Disease Control and Prevention for the pur20 pose of carrying out this section, there is authorized to 

21 be appropriated to such Centers for such purpose 

22 $8,200,000 for each of the fiscal years 2006 through 

23 2010. 
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1 SEC. 5. GRANTS FOR COMMUNITY OUTREACH REGARDING 

2 ASTHMA INFORMATION, EDUCATION, AND 

3 SERVICES. 

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

5 Human Services (in this section referred to as the ‘‘Sec6 retary’’) may make grants to nonprofit private entities for 

7 projects to carry out, in communities identified by entities 

8 applying for the grants, outreach activities to provide for 

9 residents of the communities the following: 

10 (1) Information and education on asthma. 

11 (2) Referrals to health programs of public and 

12 nonprofit private entities that provide asthma-re13 lated services, including such services for low-income 

14 individuals. The grant may be expended to make ar15 rangements to coordinate the activities of such enti16 ties in order to establish and operate networks or 

17 consortia regarding such referrals. 

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

19 grants under subsection (a), the Secretary shall give pref20 erence to applicants that will carry out projects under such 

21 subsection in communities that are disproportionately af22 fected by asthma or underserved with respect to the activi23 ties described in such subsection and in which a significant 

24 number of low-income individuals reside. 

25 (c) EVALUATIONS.—A condition for a grant under 

26 subsection (a) is that the applicant for the grant agree 
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1 to provide for the evaluation of the projects carried out 

2 under such subsection by the applicant to determine the 

3 extent to which the projects have been effective in carrying 

4 out the activities referred to in such subsection. 

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

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

7 for each of the fiscal years 2006 through 2010. 

8 SEC. 6. ACTION PLANS OF STATES REGARDING ASTHMA; FI9 NANCIAL INCENTIVES REGARDING CHIL10 DREN’S HEALTH INSURANCE PROGRAM. 

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

12 Human Services (in this section referred to as the ‘‘Sec13 retary’’) shall in accordance with subsection (b) carry out 

14 a program to encourage the States to implement plans to 

15 carry out activities to assist children with respect to asth16 ma in accordance with guidelines of the National Heart, 

17 Lung, and Blood Institute. 

18 (b) RELATION TO CHILDREN’S HEALTH INSURANCE

19 PROGRAM.— 

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

21 a State plan under title XXI of the Social Security 

22 Act provides for activities described in subsection (a) 

23 to an extent satisfactory to the Secretary, the Sec24 retary shall, with amounts appropriated under sub-
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1 section (c), make a grant to the State involved to as2 sist the State in carrying out such activities. 

3 (2) REQUIREMENT OF MATCHING FUNDS.— 

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

5 costs of the activities to be carried out by a 

6 State pursuant to paragraph (1), the Secretary 

7 may make a grant under such paragraph only 

8 if the State agrees to make available (directly 

9 or through donations from public or private en10 tities) non-Federal contributions toward such 

11 costs in an amount that is not less than 50 per12 cent of the costs ($1 for each $1 of Federal 

13 funds provided in the grant). 

14 (B) DETERMINATION OF AMOUNT CON15 TRIBUTED.—Non-Federal contributions re16 quired in subparagraph (A) may be in cash or 

17 in kind, fairly evaluated, including plant, equip18 ment, or services. Amounts provided by the 

19 Federal Government, or services assisted or 

20 subsidized to any significant extent by the Fed21 eral Government, may not be included in deter22 mining the amount of such non-Federal con23 tributions. 

24 (3) CRITERIA REGARDING ELIGIBILITY FOR

25 GRANT.—The Secretary shall publish in the Federal 
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1 Register criteria describing the circumstances in 

2 which the Secretary will consider a State plan to be 

3 satisfactory for purposes of paragraph (1). 

4 (4) TECHNICAL ASSISTANCE.—With respect to 

5 State plans under title XXI of the Social Security 

6 Act, the Secretary, acting through the Director of 

7 the Centers for Disease Control and Prevention, 

8 shall make available to the States technical assist9 ance in developing the provisions of such plans that 

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

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

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

13 for each of the fiscal years 2006 through 2010. 

14 SEC. 7. ACTION PLANS OF LOCAL EDUCATIONAL AGENCIES 

15 REGARDING ASTHMA. 

16 (a) IN GENERAL.— 

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

18 Secretary of Education (in this section referred to as 

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

20 of the Centers for Disease Control and Prevention 

21 and the Director of the National Institutes of 

22 Health, may make grants to local educational agen23 cies for programs to carry out at elementary and 

24 secondary schools specified in paragraph (2) asthma- 
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1 related activities for children who attend such 

2 schools. 

3 (2) ELIGIBLE SCHOOLS.—The elementary and 

4 secondary schools referred to in paragraph (1) are 

5 such schools that are located in communities with a 

6 significant number of low-income or underserved in7 dividuals (as defined by the Secretary). 

8 (b) DEVELOPMENT OF PROGRAMS.—Programs under 

9 subsection (a) shall include grants under which local edu10 cation agencies and State public health officials collabo11 rate to develop programs to improve the management of 

12 asthma in school settings. 

13 (c) CERTAIN GUIDELINES.—Programs under sub14 section (a) shall be carried out in accordance with applica15 ble guidelines or other recommendations of the National 

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

17 and Blood Institute) and the Environmental Protection 

18 Agency. 

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

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

21 following: 

22 (1) Identifying and working directly with local 

23 hospitals, community clinics, advocacy organizations, 

24 parent-teacher associations, and asthma coalitions. 
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1 (2) Identifying asthmatic children and training 

2 them and their families in asthma self-management. 

3 (3) Purchasing asthma equipment. 

4 (4) Hiring school nurses. 

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

6 other school personnel in asthma-symptom recogni7 tion and emergency responses. 

8 (6) Simplifying procedures to improve students’ 

9 safe access to their asthma medications. 

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

11 Secretary determines to be appropriate. 

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

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

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

15 terms in the Elementary and Secondary Education Act of 

16 1965. 

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

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

19 for each of the fiscal years 2006 through 2010. 

20 SEC. 8. SENSE OF CONGRESS REGARDING HOSPITALS AND 

21 MANAGED CARE PLANS. 

22 It is the sense of the Congress that— 

23 (1) hospitals should be encouraged to offer 

24 asthma-related education and training to asthma pa-
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1 tients and their families upon discharge from the 

2 hospital of such patients; 

3 (2) hospitals should, with respect to information 

4 on asthma, establish telephone services for patients 

5 and communicate with providers of primary health 

6 services; and 

7 (3) managed care organizations should— 

8 (A) be encouraged to disseminate to health 

9 care providers asthma clinical practice guide10 lines developed or endorsed by the Public 

11 Health Service; 

12 (B) collect and maintain asthma data; and 

13 (C) offer asthma-related education and 

14 training to asthma patients and their families. 

15 SEC. 9. SENSE OF CONGRESS REGARDING IMPLEMENTA16 TION OF ACT. 

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

18 and local asthma-related activities should— 

19 (1) promote the guidelines and other rec20 ommendations of the Public Health Service on asth21 ma diagnosis and management; and 

22 (2) be designed in consultation with national 

23 and local organizations representing the medical, 

24 educational, and environmental communities, as well 
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1 as advocates that represent those affected by asth2 ma. 

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