I 
107TH CONGRESS 
2D SESSION 
H. R. 5633
To ensure that children at highest risk for asthma are identified and treated. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 10, 2002
Mr. SIMMONS (for himself, Mrs. THURMAN, Mr. SMITH of New Jersey, Mr. 
CUMMINGS, Mr. BLAGOJEVICH, and Mr. HOBSON) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Education and the Work-
force, 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 ensure that children at highest risk for asthma are 
identified and treated.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; FINDINGS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Federal Asthma Assessment and State Tracking Act of 
2002’’ (FAAST Act). 
(b) FINDINGS.—Congress finds the following:
(1) ASTHMA SUMMARY.—Asthma is a serious 
chronic condition affecting many Americans. Asthma 
accounts for an estimated 3 million lost workdays 
for adults and 10.1 million lost school days in chil-
dren annually. Over the past 20 years mortality, 
morbidity, and hospital discharge rates attributed to 
asthma have substantially increased. Between 1979 
and 1998, the age-adjusted mortality rate increased 
56 percent while the prevalence rate increased by al-
most 22 percent in males and 97 percent in females 
between 1982 and 1996. 
(2) RACE-SPECIFIC
PREVALENCE.—In 1996, 
the prevalence rate of asthma in whites was 53.5 per 
1,000 persons while the prevalence rate in blacks 
was 69.6 per 1,000 persons. Both of these rates rep-
resent significant differences from the rates reported 
in 1982, when they were 34.6 and 39.2 for whites 
and blacks, respectively. 
(3) ECONOMIC COSTS OF ASTHMA.—Asthma en-
tails an annual economic cost to the Nation in direct 
health care costs of $8.1 billion; indirect costs (lost 
productivity) add another $4.6 billion for a total of 
$12.7 billion. Inpatient hospital services represented 
the largest single direct medical expenditure, over 
$3.5 billion. The value of reduced productivity due
to loss of school days represented the largest single 
indirect cost at $1.5 billion. 
SEC. 2. ASTHMA SCREENING FOR EARLY HEAD START AND 
HEAD START PROGRAMS. 
(a) EARLY HEAD START PROGRAMS.—Section 645A 
of the Head Start Act (42 U.S.C. 9840a) is amended by 
adding at the end the following: 
‘‘(h) ASTHMA SCREENING.—
‘‘(1) IN GENERAL.—An entity that receives as-
sistance under this section may carry out a program 
under which the entity—
‘‘(A) determines whether a child eligible to 
participate in the program described in sub-
section (a) has each received an asthma screen-
ing test using a test that is appropriate for age 
and risk factors on the enrollment of the child 
in the program; and 
‘‘(B) in the case of a child who has not re-
ceived such an asthma screening test, ensures 
that the enrolled child receives such a test ei-
ther by referral or by performing the test 
(under contract or otherwise). 
‘‘(2) REIMBURSEMENT.—
‘‘(A) IN GENERAL.—On the request of an 
entity that performs or arranges for the per-
formance of an asthma screening test under 
paragraph (1) on a child who is eligible for or 
receiving medical assistance under a State plan 
under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.), the Secretary of Health 
and Human Services, notwithstanding any 
other provision of, or limitation under, title 
XIX of the Social Security Act, shall reimburse 
the entity, from funds that are made available 
under that title, for 100 percent of the cost of 
the test and data reporting. 
‘‘(B) COSTS.—The costs of a test con-
ducted under this subsection—
‘‘(i) shall include reimbursement for 
testing devices and associated supplies ap-
proved for sale by the Food and Drug Ad-
ministration and used in compliance with 
section 353 of the Public Health Service 
Act (42 U.S.C. 263a); and 
‘‘(ii) shall include reimbursement for 
administering the tests and related serv-
ices, as determined appropriate by the 
State agency. 
‘‘(3) HEAD START.—This subsection shall apply 
to Head Start programs that include coverage, di-
rectly or indirectly, for infants and toddlers under 
the age of 3 years.’’. 
(b) HEAD START PROGRAMS.—Section 642(b) of the 
Head Start Act (42 U.S.C. 9837(b)) is amended—
(1) in paragraph (10), by striking ‘‘and’’ at the 
end;
(2) in paragraph (11), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(12) with respect to an agency that elects to 
carry out a program under section 645A(h), comply 
with the requirements of such section in the case of 
each child eligible to participate in the Head Start 
program to be carried out by the agency.’’. 
SEC. 3. ASTHMA SCREENING AND TREATMENT FOR CHIL-
DREN ENROLLED IN PUBLIC SCHOOLS. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by adding at the end 
the following: 
‘‘SEC. 320B. ASTHMA SCREENING AND TREATMENT FOR 
CHILDREN ENROLLED IN PUBLIC SCHOOLS. 
‘‘(a) GRANTS.—The Secretary shall award grants to 
eligible local educational agencies to enable such agencies 
to carry out asthma health screening and case manage-
ment programs determined appropriate by the Secretary
in accordance with the program elements described in sub-
section (d). 
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 
under subsection (a), a local educational agency shall pre-
pare and submit to the Secretary an application at such 
time, in such manner, and containing such information as 
the Secretary may require. 
‘‘(c) PREFERENCE.—In awarding grants under this 
section, the Secretary shall give preference to local edu-
cational agencies serving schools that are located in areas 
with a high incidence of childhood asthma or a high death 
rate associated with childhood asthma. 
‘‘(d) PROGRAM ELEMENTS.—Under an asthma pro-
gram operated under a grant under this section, a local 
educational agency shall—
‘‘(1) determine whether a child enrolled in a 
school in which the program is in effect has received 
an asthma screening test using a test that is appro-
priate for age and risk factors on the enrollment of 
the child in the school; 
‘‘(2) in the case of a child who has not received 
an asthma screening test, ensure that the child re-
ceives such a test either by referral or by performing 
the test (under contract or otherwise); and
‘‘(3) in the case of a child determined to have 
asthma, provide treatment or refer the child for 
treatment (including case management) and edu-
cation in the management of asthma. 
‘‘(e) REIMBURSEMENT.—
‘‘(1) CHILDREN
ENROLLED
IN
OR
ELIGIBLE 
FOR MEDICAID.—
‘‘(A) IN
GENERAL.—With respect to a 
child who is eligible for or receiving medical as-
sistance under a State plan under title XIX of 
the Social Security Act (42 U.S.C. 1396 et 
seq.) and who receives, or is provided, a test, 
treatment, or education, under a program es-
tablished under subsection (a), the Secretary, 
notwithstanding any other provision of, or limi-
tation under, such title XIX, including the pay-
ment limitation commonly known as the ‘free 
care rule’, shall reimburse the local educational 
agency administering such program from funds 
that are made available under such title XIX 
for 100 percent of the cost of the performance, 
arrangement, or provision and data reporting. 
‘‘(B) COSTS.—The costs of a test con-
ducted under this section shall include reim-
bursement for—
‘‘(i) testing devices and associated 
supplies approved for sale by the Food and 
Drug Administration and used in compli-
ance with section 353; and 
‘‘(ii) administering the tests and re-
lated services, as determined appropriate 
by the State agency responsible for the ad-
ministration of title XIX of the Social Se-
curity Act (42 U.S.C. 1396 et seq.). 
‘‘(2) CHILDREN
ENROLLED
IN
OR
ELIGIBLE 
FOR SCHIP.—
‘‘(A) IN
GENERAL.—With respect to a 
child who is eligible for or receiving child health 
assistance under a State plan under title XXI 
of the Social Security Act (42 U.S.C. 1397aa et 
seq.) and who receives, or is provided, a test, 
treatment, or education under a program estab-
lished under subsection (a), the Secretary, not-
withstanding any other provision of, or limita-
tion under, such title XXI, or any other provi-
sion of law (including the payment limitation 
under title XIX commonly known as the ‘free 
care rule’ to the extent, if any, such limitation 
applies to the State children’s health insurance 
program established under title XXI of that
Act), shall reimburse the local educational agen-
cy administering such program from funds that 
are made available under such title XXI for 
100 percent of the cost of the performance, ar-
rangement, or provision and data reporting. 
‘‘(B) COSTS.—The costs shall include the 
costs described in paragraph (1)(B). 
‘‘(f) DEFINITIONS.—In this section, the terms ‘local 
educational agency’, ‘elementary school’, and ‘secondary 
school’ have the meanings given such terms in section 
9101 of the Elementary and Secondary Education Act of 
1965 (20 U.S.C. 7801). 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
with respect to a child, and any data reporting with re-
spect to the child, who is not eligible for coverage under 
title XIX or XXI of the Social Security Act, or is not oth-
erwise 
covered 
under 
a 
health 
insurance 
plan, 
$15,000,000 for each of fiscal years 2003 through 2008. 
‘‘(h) EVALUATIONS.—Not later than 4 years after the 
date of enactment of this section, the Secretary shall pre-
pare and submit to the appropriate committees of Con-
gress a report containing data related to whether grants 
provided under this section have ensured that children at 
the highest risk for asthma are identified and treated.’’.
SEC. 4. PAYMENTS FOR SCREENING AND TREATMENT PRO-
VIDED TO CHILDREN ELIGIBLE UNDER MED-
ICAID OR SCHIP. 
(a) MEDICAID.—Section 1903(c) of the Social Secu-
rity Act (42 U.S.C. 1396b(c)) is amended—
(1) by inserting ‘‘(1)’’ after ‘‘(c)’’; and 
(2) by adding at the end the following: 
‘‘(2) Nothing in this title or any other provision of 
law, including the payment limitation commonly known as 
the ‘free care rule’, shall be construed as prohibiting or 
restricting, or authorizing the Secretary to prohibit or re-
strict, payment under subsection (a) for medical assist-
ance for covered services furnished to a child who is eligi-
ble for or receiving medical assistance under the State 
plan and who receives an asthma screening test, or is pro-
vided treatment or education in disease management relat-
ing to asthma, through a public elementary or secondary 
school, whether directly or indirectly, and regardless of 
whether the school participates in a program established 
under subsection (a) or (b) of section 1120B of the Ele-
mentary and Secondary Education Act of 1965.’’. 
(b) SCHIP.—Section 2105 of the Social Security Act 
(42 U.S.C. 1397ee) is amended by adding at the end the 
following: 
‘‘(g) REQUIRED PAYMENT FOR CERTAIN SCHOOL-
BASED SERVICES.—Nothing in this title or any other pro-
vision of law (including the payment limitation under title 
XIX commonly known as the ‘free care rule’ to the extent, 
if any, such limitation applies to the program established 
under this title) shall be construed as prohibiting or re-
stricting, or authorizing the Secretary to prohibit or re-
strict, payment under subsection (a) for child health as-
sistance for covered services furnished to a child who is 
eligible for or receiving such assistance under the State 
child health plan and who receives an asthma screening 
test that is available to children receiving assistance under 
the State plan, or is provided treatment or education in 
disease management relating to asthma through a public 
elementary or secondary school, whether directly or indi-
rectly, and regardless of whether the school participates 
in a program established under subsection (a) or (b) of 
section 1120B of the Elementary and Secondary Edu-
cation Act of 1965.’’. 
SEC. 5. MODEL ASTHMA TREATMENTS CENTERS DEM-
ONSTRATION PROGRAM. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services (in this section referred to as the ‘‘Sec-
retary’’) shall develop, in conjunction with State medicaid 
programs under title XIX of the Social Security Act, a 
demonstration program for model asthma treatment cen-
ters. In developing the program, the Secretary shall base