I 
109TH CONGRESS 
1ST SESSION H. R. 4166 
To amend the Public Health Service Act with regard to research on asthma, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 27, 2005 
Mrs. MCCARTHY (for herself and Mr. SCHWARZ of Michigan) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
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 Representa-
tives 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. 
Congress makes the following findings: 
(1) The number of people with asthma has 
more than doubled from 1985 to 2005. According to 
the Centers for Disease Control and Prevention, in 
2002, more than 20,000,000 Americans had been di-
agnosed with asthma, and an estimated 6,000,000 
children were suffering from asthma. By 2020, asth-
ma is expected to strike 1 in 14 Americans and 1 
in 5 families. 
(2) According to the Centers for Disease Con-
trol and Prevention, in 2002, more than 4,000 
Americans died from asthma. The Asthma and Al-
lergy Foundation of America reports that in the 
United States, 14 individuals die of asthma every 
day. According to the Centers for Disease Control 
and Prevention’s National Center for Health Statis-
tics, mortality from asthma is higher among Afri-
can-Americans and women. 
(3) According to the Centers for Disease Con-
trol and Prevention, asthma accounts for nearly 
500,000 hospitalizations each year. More than 
1,900,000 people are treated for asthma attacks in 
hospital emergency departments each year. 
(4) The Morbidity and Mortality Weekly Report 
notes that from 1980 to 1999, the number of physi-
cian office visits increased from 5,900,000 to 
10,800,000. There were higher rates of physician of-
fice visits for African-Americans, females, and chil-
dren.
(5) According to the National Heart Lung and 
Blood Institute at the National Institutes of Health, 
the annual cost of asthma to the United States is 
approximately $16,100,000,000. 
(6) The Department of Education states that 
asthma is the most commonly cited reason for school 
absences. According to the Centers for Disease Con-
trol and Prevention, in 2002, more than 14,000,000 
school days and 11,800,00 work days were missed as 
a result of asthma. 
(7) Asthma episodes can be triggered by both 
outdoor air pollution and indoor air pollution, in-
cluding pollutants such as cigarette smoke and com-
bustion by-productions. Asthma episodes can also be 
triggered by indoor allergens such as animal dander 
and outdoor allergens such as pollen and molds. 
(8) 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 asthma care from 
specialists results in improved asthma outcomes at a 
lower cost.
(9) The alarming rise in the prevalence of asth-
ma, its adverse effects on school attendance and pro-
ductivity, its costs for hospitalizations and emer-
gency 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 num-
ber and severity of asthma attacks, its financial bur-
den, and the health disparities associated with asth-
ma. 
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 by adding at the end 
the following: 
‘‘SEC. 399O. FAMILY ASTHMA CLINICAL AND ENVIRON-
MENTAL HEALTH RESEARCH GRANT PRO-
GRAM. 
‘‘(a) PURPOSES.—The purposes of this section are to 
provide authority to award grants to eligible entities serv-
ing a medically underserved population (as defined in sec-
tion 330(b)(3)) for the conduct of pilot projects to prevent 
and control asthma symptoms and to reduce asthma at-
tacks in families containing individuals with asthma 
through activities which may include— 
‘‘(1) researching and developing novel interven-
tions to reduce the burden of asthma, improve dis-
ease control, assist with the management of asthma 
exacerbations by patients and their families, and 
prevent asthma exacerbations; 
‘‘(2) utilizing the electronic medical record, tele-
health, and other novel electronic communications to 
prevent acute asthma attacks; 
‘‘(3) facilitating communication of intervention 
and prevention information to individuals with asth-
ma and their families and caregivers; 
‘‘(4) expanding the understanding of environ-
mental and other factors that cause and contribute 
to the burden of asthma; 
‘‘(5) collecting and analyzing data in order to 
determine the incidence, prevalence, and severity of 
asthma and associated risk factors; and 
‘‘(6) expanding data collection of research into 
the genetic susceptibility to asthma. 
‘‘(b) AUTHORITY TO MAKE 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 a 
medically underserved population; and 
‘‘(B) give consideration to an adequate 
rural-urban distribution, so as to gain better in-
formation about asthma at the national level. 
‘‘(3) COORDINATION OF AGENCIES.—The Na-
tional Institute of Environmental Health Sciences 
(which shall be the lead agency for purposes of ac-
tivities carried out under this section), in coordina-
tion with the National Heart, Lung, and Blood In-
stitute, the National Institute of Allergy and Infec-
tious 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 Insti-
tutes shall coordinate in writing a Request for Appli-
cations, reviewing applications, and providing admin-
istrative 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 children’s hospitals; 
‘‘(2) a community health center; 
‘‘(3) a medical school; 
‘‘(4) a nonprofit institution; or 
‘‘(5) another entity, as designated by the Sec-
retary. 
‘‘(d) APPLICATION.— 
‘‘(1) IN GENERAL.—An eligible entity shall sub-
mit 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, to the extent 
practicable— 
‘‘(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 pa-
tients using the Internet or telephone for the 
prompt transmission of patient information re-
lated to symptoms and conditions, such as peak 
flow meter measurements; 
‘‘(C) provide assurance that enrollees will 
have baseline and ongoing medical data col-
lected, including data related to pulmonary 
function and skin or in vitro testing for sen-
sitization 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 pre-
serve patient confidentiality, with at least 1 of 
the Asthma Clinical Centers of the National In-
stitutes of Health; and 
‘‘(F) provide assurances that the entity 
can effectively coordinate care between physi-
cians, including asthma specialists, nurses, al-
lied health professionals, community health
workers, nonprofit organizations, and the other 
entities responsible for implementing the pilot 
project involved. 
‘‘(3) COLLABORATION
WITH
LOCAL
INSTITU-
TIONS.—An eligible entity under this section is en-
couraged 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 applicant. 
‘‘(e) USE OF FUNDS.— 
‘‘(1) IN GENERAL.—An eligible entity shall use 
amounts received under a grant under this section to 
carry out the purposes described in subsection (a), 
including— 
‘‘(A) conducting an assessment of the pa-
tients served to determine possible contributors 
to asthma exacerbations in the indoor and out-
door environments, including exposure to diesel 
and other particles, ozone and other gases, gas-
eous pollutants and allergens, mold, and other 
indoor pollutants; 
‘‘(B) implementing interventions regarding 
indoor and outdoor environments to reduce the 
severity and persistence of asthma; 
‘‘(C) developing and maintaining question-
naires completed by the patients, or the parents 
or guardians of the patients, regarding their re-
spective occupations and personal exposure his-
tory, in order to increase the understanding of 
factors that contribute to asthma prevalence; 
and 
‘‘(D) conducting other research as des-
ignated by the Director of the National Insti-
tutes of Health, particularly in areas that will 
advance knowledge of the factors that con-
tribute to asthma. 
‘‘(2) RESEARCH OF SIGNIFICANT INTEREST.— 
An eligible entity is encouraged to conduct research 
under this section on the interactions between envi-
ronmental exposures and genetic susceptibilities that 
contribute to the development or exacerbation of 
asthma.
‘‘(f) PROTECTION OF INFORMATION.—The Secretary 
shall ensure the protections of individual health privacy 
under this section consistent with the regulations promul-
gated under section 264(c) of the Health Insurance Port-
ability and Accountability Act of 1996. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated $10,000,000 for each 
of fiscal years 2006 through 2010 to carry out this sec-
tion.’’. 
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 sec-
tion 424B the following: 
‘‘SEC. 424C. EXPANSION OF THE NATIONAL ASTHMA EDU-
CATION AND PREVENTION PROGRAM. 
‘‘(a) DEVELOPMENT OF A NATIONAL ASTHMA AC-
TION PLAN.— 
‘‘(1) IN GENERAL.—In addition to any other 
authorization of appropriation available to the Na-
tional Heart, Lung, and Blood Institute for the pur-
pose of carrying out the National Asthma Education 
and Prevention Program (referred to in this section 
as the ‘Program’), there is authorized to be appro-
priated to such Institute $1,000,000 for each of fis-
cal years 2006 through 2010 to develop a National 
Asthma Action Plan. 
‘‘(2) USE OF APPROPRIATIONS.—The amount 
appropriated under 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 enactment of the Family Asthma 
Act, the Program shall, in consultation with patient 
groups, nonprofit organizations, medical societies, 
and other relevant governmental and nongovern-
mental entities that participate in the Program, sub-
mit to Congress a report that— 
‘‘(A) catalogs, with respect to asthma pre-
vention, management, and surveillance— 
‘‘(i) the activities of the Federal Gov-
ernment, including an assessment of the 
progress of the Federal Government and 
States, with respect to achieving the goals 
of the Healthy People 2010 initiative; and 
‘‘(ii) the activities of other entities 
that participate in the Program, including