I 
108TH CONGRESS 
1ST SESSION H. R. 2018
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 7, 2003
Mrs. LOWEY (for herself, Mr. HINCHEY, Mr. GREEN of Texas, Ms. NORTON, 
Ms. DELAURO, Mr. EMANUEL, Mrs. CHRISTENSEN, Mr. RANGEL, Mr. 
TOWNS, Mr. PALLONE, Mrs. MCCARTHY of New York, Mr. KILDEE, Mr. 
ENGEL, Mr. CLYBURN, Mr. NADLER, Ms. SCHAKOWSKY, and Mr. DAVIS 
of Illinois) introduced the following bill; which was referred to the Com-
mittee 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.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Asthma Act’’.
SEC. 2. FINDINGS. 
The Congress finds as follows: 
(1) Despite improved therapies, the prevalence 
rate of asthma continues to rise, affecting an esti-
mated 17 million Americans; nearly 5 million under 
the age of 18. The prevalence of pediatric asthma 
has risen dramatically since 1980. Rates are increas-
ing for all ethnic groups, especially for African-
American and Hispanic children. 
(2) Asthma is the third leading cause of pre-
ventable hospitalizations. Improper diagnosis and 
poor management of asthma resulted in 1.6 million 
people being treated for asthma attacks in the emer-
gency room in 1995. 
(3) Asthma can be life-threatening if not prop-
erly managed. Most asthma-related deaths are pre-
ventable, yet such deaths continue to rise in the U.S. 
Each day, 14 Americans die of asthma. 
(4) The cost of asthma to the U.S. was $11.3 
billion in 1998, and the rise in asthma prevalence 
will lead to higher costs in the future. 
(5) With early recognition of the signs and 
symptoms of asthma, proper diagnosis and treat-
ment, and patient education and self-management, 
asthma is a controllable disease.
(6) Public health interventions have been prov-
en effective in the treatment and management of 
asthma. Population-based research supported by the 
National Institutes of Health (NIH) has effectively 
demonstrated the benefits of combining aggressive 
medical treatment with patient education to improve 
the management of asthma. The National Asthma 
Education and Prevention Program (NAEPP) helps 
raise awareness that asthma is a serious chronic dis-
ease, and helps promote more effective management 
of asthma through patient and professional edu-
cation. 
(7) The alarming rise in prevalence, asthma-re-
lated deaths, and expenditures demonstrate that, de-
spite extensive knowledge on effective asthma man-
agement strategies, current federal policy and fund-
ing regarding the education, treatment, and manage-
ment of asthma is inadequate. 
(8) Additional Federal direction, funding, and 
support is necessary to increase awareness of asth-
ma as a chronic illness, its symptoms, and the envi-
ronmental factors (indoor and outdoor) that affect 
the disease, as well as to promote education pro-
grams that teach patients how to better manage 
asthma.
SEC. 3. PROVISIONS REGARDING NATIONAL ASTHMA EDU-
CATION AND PREVENTION PROGRAM OF NA-
TIONAL HEART, LUNG, AND BLOOD INSTI-
TUTE. 
(a) ADDITIONAL FUNDING; EXPANSION
OF PRO-
GRAM.—In addition to any other authorization of appro-
priations that is available to the National Heart, Lung, 
and Blood Institute for the purpose of carrying out the 
National Asthma Education and Prevention Program, 
there is authorized to be appropriated to such Institute 
for such purpose $4,100,000 for each of the fiscal years 
2004 through 2008. Amounts appropriated under the pre-
ceding sentence shall be expended to expand such Pro-
gram. 
(b) COORDINATING COMMITTEE.—
(1) REPORT TO CONGRESS.—With respect to 
the coordinating committee established for the Na-
tional Asthma Education and Prevention Program of 
the National Heart, Lung, and Blood Institute, such 
committee shall submit to the Congress a report 
that—
(A) contains a determination by the com-
mittee of the scope of the problem of asthma in 
the United States; 
(B) identifies all Federal programs that 
carry out asthma-related activities; and
(C) contains the recommendations of the 
committee for strengthening and better coordi-
nating the asthma-related activities of the Fed-
eral Government. 
(2) INCLUSION
OF
REPRESENTATIVE
OF
DE-
PARTMENT OF EDUCATION.—The Secretary of Edu-
cation or a designee of the Secretary shall be in-
cluded in the membership of the coordinating com-
mittee referred to in paragraph (1). 
SEC. 4. ASTHMA-RELATED ACTIVITIES OF CENTERS FOR 
DISEASE CONTROL AND PREVENTION. 
(a) EXPANSION OF PUBLIC HEALTH SURVEILLANCE 
ACTIVITIES; PROGRAM
FOR PROVIDING INFORMATION 
AND EDUCATION TO PUBLIC.—The Secretary of Health 
and Human Services, acting through the Director of the 
Centers for Disease Control and Prevention, shall collabo-
rate with the States to expand the scope of—
(1) activities that are carried out to determine 
the incidence and prevalence of asthma; and 
(2) activities that are carried out to prevent the 
health consequences of asthma, including through 
the provision of information and education to the 
public regarding asthma, which may include the use 
of public service announcements through the media
and such other means as such Director determines 
to be appropriate. 
(b) COMPILATION
OF
DATA.—The Secretary of 
Health and Human Services, acting through the Director 
of the Centers for Disease Control and Prevention and in 
consultation with the National Asthma Education Preven-
tion Program Coordinating Committee, shall—
(1) conduct local asthma surveillance activities 
to collect data on the prevalence and severity of 
asthma and the quality of asthma management, in-
cluding—
(A) telephone surveys to collect sample 
household data on the local burden of asthma; 
and 
(B) health care facility specific surveillance 
to collect asthma data on the prevalence and se-
verity of asthma, and on the quality of asthma 
care; and 
(2) compile and annually publish data on—
(A) the prevalence of children suffering 
from asthma in each State; and 
(B) the childhood mortality rate associated 
with asthma nationally and in each State. 
(c) ADDITIONAL FUNDING.—In addition to any other 
authorization of appropriations that is available to the
Centers for Disease Control and Prevention for the pur-
pose of carrying out this section, there is authorized to 
be appropriated to such Centers for such purpose 
$8,200,000 for each of the fiscal years 2004 through 
2008. 
SEC. 5. GRANTS FOR COMMUNITY OUTREACH REGARDING 
ASTHMA INFORMATION, EDUCATION, AND 
SERVICES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) may make grants to nonprofit private entities for 
projects to carry out, in communities identified by entities 
applying for the grants, outreach activities to provide for 
residents of the communities the following: 
(1) Information and education on asthma. 
(2) Referrals to health programs of public and 
nonprofit private entities that provide asthma-re-
lated services, including such services for low-income 
individuals. The grant may be expended to make ar-
rangements to coordinate the activities of such enti-
ties in order to establish and operate networks or 
consortia regarding such referrals. 
(b) PREFERENCES IN MAKING GRANTS.—In making 
grants under subsection (a), the Secretary shall give pref-
erence to applicants that will carry out projects under such
subsection in communities that are disproportionately af-
fected by asthma or underserved with respect to the activi-
ties described in such subsection and in which a significant 
number of low-income individuals reside. 
(c) EVALUATIONS.—A condition for a grant under 
subsection (a) is that the applicant for the grant agree 
to provide for the evaluation of the projects carried out 
under such subsection by the applicant to determine the 
extent to which the projects have been effective in carrying 
out the activities referred to in such subsection. 
(d) FUNDING.—For the purpose of carrying out this 
section, there is authorized to be appropriated $4,100,000 
for each of the fiscal years 2004 through 2008. 
SEC. 6. ACTION PLANS OF STATES REGARDING ASTHMA; FI-
NANCIAL 
INCENTIVES 
REGARDING 
CHIL-
DREN’S HEALTH INSURANCE PROGRAM. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall in accordance with subsection (b) carry out 
a program to encourage the States to implement plans to 
carry out activities to assist children with respect to asth-
ma in accordance with guidelines of the National Heart, 
Lung, and Blood Institute. 
(b) RELATION TO CHILDREN’S HEALTH INSURANCE 
PROGRAM.—
(1) IN GENERAL.—Subject to paragraph (2), if 
a State plan under title XXI of the Social Security 
Act provides for activities described in subsection (a) 
to an extent satisfactory to the Secretary, the Sec-
retary shall, with amounts appropriated under sub-
section (c), make a grant to the State involved to as-
sist the State in carrying out such activities. 
(2) REQUIREMENT OF MATCHING FUNDS.—
(A) IN
GENERAL.—With respect to the 
costs of the activities to be carried out by a 
State pursuant to paragraph (1), the Secretary 
may make a grant under such paragraph only 
if the State agrees to make available (directly 
or through donations from public or private en-
tities) non-Federal contributions toward such 
costs in an amount that is not less than 50 per-
cent of the costs ($1 for each $1 of Federal 
funds provided in the grant). 
(B) DETERMINATION
OF
AMOUNT
CON-
TRIBUTED.—Non-Federal 
contributions 
re-
quired in subparagraph (A) may be in cash or 
in kind, fairly evaluated, including plant, equip-
ment, or services. Amounts provided by the 
Federal Government, or services assisted or 
subsidized to any significant extent by the Fed-
eral Government, may not be included in deter-
mining the amount of such non-Federal con-
tributions. 
(3) CRITERIA
REGARDING
ELIGIBILITY
FOR 
GRANT.—The Secretary shall publish in the Federal 
Register criteria describing the circumstances in 
which the Secretary will consider a State plan to be 
satisfactory for purposes of paragraph (1). 
(4) TECHNICAL ASSISTANCE.—With respect to 
State plans under title XXI of the Social Security 
Act, the Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, 
shall make available to the States technical assist-
ance in developing the provisions of such plans that 
will provide for activities pursuant to paragraph (1). 
(c) FUNDING.—For the purpose of carrying out this 
section, there is authorized to be appropriated $4,100,000 
for each of the fiscal years 2004 through 2008. 
SEC. 7. ACTION PLANS OF LOCAL EDUCATIONAL AGENCIES 
REGARDING ASTHMA. 
(a) IN GENERAL.—. 
(1) SCHOOL-BASED ASTHMA ACTIVITIES.—The 
Secretary of Education (in this section referred to as 
the ‘‘Secretary’’), in consultation with the Director 
of the Centers for Disease Control and Prevention
and the Director of the National Institutes of 
Health, may make grants to local educational agen-
cies for programs to carry out at elementary and 
secondary schools specified in paragraph (2) asthma-
related activities for children who attend such 
schools. 
(2) ELIGIBLE SCHOOLS.—The elementary and 
secondary schools referred to in paragraph (1) are 
such schools that are located in communities with a 
significant number of low-income or underserved in-
dividuals (as defined by the Secretary). 
(b) DEVELOPMENT OF PROGRAMS.—Programs under 
subsection (a) shall include grants under which local edu-
cation agencies and State public health officials collabo-
rate to develop programs to improve the management of 
asthma in school settings. 
(c) CERTAIN GUIDELINES.—Programs under sub-
section (a) shall be carried out in accordance with applica-
ble guidelines or other recommendations of the National 
Institutes of Health (including the National Heart, Lung, 
and Blood Institute) and the Environmental Protection 
Agency. 
(d) CERTAIN ACTIVITIES.—Activities that may be 
carried out in programs under subsection (a) include the 
following: